A never-before-seen virus, detected in the central Chinese city of Wuhan, has claimed nine lives and infected hundreds of Chinese citizens with a pneumonia-like illness, according to China’s National Health Commission. It was first reported to the World Health Organization on Dec. 31, 2019 and has been under investigation since. WHO indicates there are still many unknowns, butthe same family as the deadly SARS and MERS viruses.
Scientists are yet to fully understand how destructive the new virus, dubbed 2019-nCoV, might be. Researchers and investigators are just beginning to understand where it originated, how it is transmitted, how far it has spread and what symptoms patients present with.
As of Jan. 21, case numbers have skyrocketed to over 440 in China and abroad. Chinese authorities also confirmed health workers have been infected with virus, suggesting it has achieved human-to-human transmission. As a result, authorities are taking steps to guard against its spread and the WHO will convene an Emergency Committee to explore whether the virus constitutes a public health emergency on Wednesday, Jan. 22. Researchers believe the number of cases may be higher than current reports suggest, and three US airports have begun to screen incoming passengers for signs of illness, as have busy airports in Hong Kong, Singapore, South Korea and Malaysia.
Here’s everything we know about the mystery virus and steps you can take to reduce your risk of coronavirus
What is a coronavirus?
Coronaviruses belong to a family of viruses known as Coronaviridae and look like spiked rings under an electron microscope. They are so named because of these spikes, which form a halo around their viral envelope.
Coronaviruses contain a strand of RNA within their envelope and cannot reproduce without getting inside living cells and hijacking the machinery found within. The spikes on their viral envelope help them bind to cells, which gives them a way in. It’s like blasting the door open with C4. Once inside they turn the cell into a virus factory, using its molecular conveyor belt to produce more viruses which are then shipped out. The virus progeny infect another cell and the cycle starts anew.
Typically, these types of viruses are found in animals ranging from livestock to household pets and wildlife such as bats. 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, they can cause severe respiratory illness.
The causative agent of severe acute respiratory syndrome and Middle East respiratory syndrome were extremely pathogenic coronaviruses, and were found to be easily transmitted from human to human. SARS infected more than 8,000 people and resulted in nearly 800 deaths, MERS almost 2,500 with over 850 deaths.
Where did the virus come from?
The virus appears to have originated in the Huanan Seafood Wholesale Market in Wuhan, a Chinese city of over 11 million people approximately 650 miles south of Beijing. The market sells fish, as well as a panoply of other animal meats. However, it’s still unknown whether it emerged from an animal species like previous coronaviruses, SARS and MERS.
Markets have been implicated in the origin and spread of viral diseases in past epidemics and a large majority of the confirmed cases seen so far had been to the Huanan Seafood marketplace in recent weeks. The market seems like an integral piece of the puzzle, but researchers will need to undertake a range of experiments and testing to confirm the virus’ origin.
“Testing of animals in the Wuhan area, including sampling from the markets, will provide more information,” said Raina MacIntyre, a head of the biosecurity research program at the University of New South Wales’ Kirby Institute.
How many confirmed cases have been reported?
Four hundred forty cases have been confirmed as of Jan. 22. The bulk are in China, but cases have been confirmed in Thailand, Japan, South Korea and now the US, where a man in his 30s in Washington state presented with the disease at a local hospital.
A list of confirmed cases and their locations are below:
- China: 440 confirmed cases
- Thailand: 2 confirmed cases
- Japan: 1 confirmed cases
- South Korea: 1 confirmed case
- US: 1 confirmed case
- Australia: 1 suspected case
National authorities in China continue to monitor over 1,300 residents who attended the Wuhan market or have had prolonged contact with those presenting symptoms of the novel disease.
China’s National Health Commission said the virus is responsible for nine deaths as of Jan. 22. The first death was a 61-year-old man who had frequented the Wuhan market and had chronic liver disease and abdominal tumors. The second was a 69-year-old man who went to a hospital with severe damage to multiple organs.
A study, published by the Imperial College London on Jan. 17, estimates the total number of 2019-nCoV cases could be much higher than reported, with over 1,700 cases. The work, led by Neil Ferguson, calculated how far the virus is likely to spread based on its incubation period and the amount of travel in and out of Wuhan since it was first detected.
WHO’s full situation report was last updated on Jan. 21 but only includes data up to Jan. 20.
How do we know it’s a new coronavirus?
In short, genes.
Chinese scientists were able to isolate and unravel the genetic code of the virus from patients, ruling out other potential causes such as influenza, and confirm it is completely new. However the genetic code shows this virus has around 70% similarity to the SARS coronavirus.
Understanding the genetic code also helps researchers in two ways: It allows them to create tests that can identify the virus from patient samples and gives them potential insight into creating treatments or vaccines.
How does the coronavirus spread?
This is one of the major questions researchers are working feverishly to answer. It’s unclear what animals may act as a reservoir for the virus and how much of a role the live animal markets play in its spread. There haven’t been reports of health officials and attendants contracting the disease, which seems to suggest human-to-human transmission is limited — but this is still being investigated.
“It does not appear to be highly contagious between humans at this stage, based on about 60 known symptomatic cases to date,” Macintyre said in a statement on Jan. 17.
The market, believed to be the epicenter of the spread, was shut down on Jan. 1. The World Health Organization has suggested that human-to-human transmission can’t be excluded at this stage, which could cause some concern for authorities looking to slow the disease.
On Jan. 20, the University of Minnesota’s Center for Infectious Disease Research and Policy reported health workers in China had been infected with the virus. This was a notable turning point in the previous SARS epidemic, as health workers moving between countries were able to aid the spread of the disease. It also confirms human-to-human transmission is likely, which could hamper efforts to contain the virus in the coming weeks.
“The major concern is hospital outbreaks, which were seen with SARS and MERS coronaviruses,” MacIntyre said. “Meticulous triage and infection control is needed to prevent these outbreaks and protect health workers.”
Tedros Adhanom Ghebreyesus, the director-general of the WHO, will convene an emergency committee on Wednesday, Jan. 22 to ascertain whether this new virus constitutes a public health emergency.
“If WHO declares a public health emergency of international concern, it enables WHO greater powers for disease control using the International Health Regulations,” MacIntyre said.
Most recently, the emergency committee was convened for the Ebola virus epidemic in the Democratic Republic of the Congo. The meeting outlined a number of key strategies and commitments to strengthen and protect against the spread of the disease.
What are the symptoms?
The novel coronavirus causes similar symptoms to 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.
Patients present with:
- Elevated body temperature
- A dry cough
- Shortness of breath or breathing difficulties.
As the disease progresses patients may also present with pneumonia, which inflames the lungs and causes them to fill with fluid which can be detected via X-ray, according to the WHO.
Is there a treatment for coronavirus?
Coronaviruses are notoriously hardy organisms. They’re effective at hiding from the human immune syste, and we haven’t developed any reliable treatments of vaccines that can eradicate them. In most cases, health officials attempt to deal with the symptoms.
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 novel disease. According to CNN, researchers at the National Institute of Health are already working on a vaccine — though note 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 the 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.
How to reduce your risk of coronavirus
With confirmed cases now seen in the US, Thailand, Japan, South Korea and potentially Australia, there is potential 2019-nCoV could be spreading much further afield. The WHO recommends a range of measures to protect yourself from contracting the disease based on good hand hygiene and good respiratory hygiene,.
A Twitter thread, developed by the WHO, is below.
This post was originally published on Jan. 19 and is updated as new information becomes available.
Another presumptive case of COVID-19 confirmed in Toronto | News – Daily Hive
Ontario health officials announced a fourth presumptive case of the novel coronavirus in the province Sunday, bringing the total number of cases Canada has seen to 10.
The latest patient is a woman who arrived in Canada from China on February 21. That same day, she followed advice from Telehealth Ontario and went to North York General Hospital because she had an intermittent cough.
Her illness was mild, and after being tested for COVID-19 she was discharged and is now self-isolated at home.
Ontario’s lab returned a presumptive positive test for the virus Sunday, and further testing will be done at the national lab in Winnipeg to confirm that result.
“Because of all the proper protocols and procedures that are in place to contain this virus and exposure to others was limited, I want to assure the public that the risk to Ontarians remains low,” said Dr. David Williams, Ontario’s Chief Medical Officer of Health.
The woman wore a mask on her flight back to Toronto, and has not been in touch with many people since she returned.
Right now, this woman is the only known active case of COVID-19 in Ontario. The first three patients who all returned from China earlier this year have recovered and cleared the virus from their bodies.
[Wuhan Woman With No Coronavirus Symptoms Infects 5 Relatives Revealing New Extent of Challenge] – Mash Viral
China: A 20-year-old Chinese woman from Wuhan, the epicenter of the coronavirus outbreak, traveled 400 miles(675 km) north to Anyang where she infected five relatives, without ever showing signs of infection, Chinese scientists reported on Friday, offering new evidence that the virus can be spread asymptomatically.
The case study, published in the Journal of the American Medical Association, offered clues about how the coronavirus is spreading, and suggested why it may be difficult to stop.
“Scientists have been asking if you can have this infection and not be ill? The answer is apparently, yes,” said Dr. William Schaffner, an infectious disease expert at Vanderbilt University Medical Center, who was not involved in the study.
China has reported a total of 75,567 cases of the virus known as COVID-19 to the World Health Organization (WHO) including 2,239 deaths, and the virus has already spread to 26 countries and territories outside of mainland China.
Researchers have reported sporadic accounts of individuals without any symptoms spreading the virus. What’s different in this study is that it offers a natural lab experiment of sorts, Schaffner said.
“You had this patient from Wuhan where the virus is, traveling to where the virus wasn’t. She remained asymptomatic and infected a bunch of family members and you had a group of physicians who immediately seized on the moment and tested everyone.”
According to the report by Dr. Meiyun Wang of the People’s Hospital of Zhengzhou University and colleagues, the woman traveled from Wuhan to Anyang on January 10 and visited several relatives. When they started getting sick, doctors isolated the woman and tested her for coronavirus. Initially, the young woman tested negative for the virus, but a follow-up test was positive.
All five of her relatives developed COVID-19 pneumonia, but as of February 11, the young woman still had not developed any symptoms, her chest CT remained normal and she had no fever, stomach or respiratory symptoms, such as cough or sore throat.
Scientists in the study said if the findings are replicated, “the prevention of COVID-19 infection could prove challenging.”
Key questions now, Schaffner said, are how often does this kind of transmission occur and when during the asymptomatic period does a person test positive for the virus.
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SARS lessons help Canada prep for COVID-19, but hospital capacity a worry – Nanaimo News Bulletin
Canadian medical experts say the country’s already overstretched emergency rooms would find it difficult to cope if a true outbreak of the novel coronavirus, or COVID-19, were to take hold in Canada.
So far, the virus has been relatively contained to mainland China, thanks in part to one of the largest quarantines in modern history.
“We must not look back and regret that we failed to take advantage of the window of opportunity that we have now,” Dr. Tedros Adhanom Ghebreyesus, director general of the World Health Organization, said in a message to all the world’s countries Friday.
The risk of contracting the virus in Canada right now is extremely low, and public health officials have been lauded for their efforts to detect and isolate the nine cases confirmed in the country so far.
The hundreds of patients across the country who have tested negative for the virus are also a sign that containment efforts are working as they should.
But Canada’s most recent case in British Columbia has raised fears about where and how the disease is being transmitted abroad. Unlike others who’ve imported the virus from China or from people who have recently been to China, the woman in her 30s contracted the illness while in Iran.
“Any imported cases linked to Iran could be an indicator that there is more widespread transmission than we know about,” said Canada’s chief medical officer Dr. Theresa Tam Friday.
Canada has taken major steps to prevent the kind of shock that befell Ontario during the outbreak of the coronavirus known as SARS in 2003 that led to 44 deaths. Creating the Public Health Agency of Canada, which Tam heads, is one of them.
The country is now better co-ordinated, has increased its lab-testing capabilities and is prepared to trace people’s contacts to find people who might have caught a contagious illness without knowing it.
But once the number of incoming cases reaches a critical mass, the approach must change, according to infectious-diseases physician Dr. Isaac Bogoch of Toronto’s University Health Network.
He likens the response to trying to catch fly balls in the outfield: as the number of balls in the air increases, they become harder and harder to snag.
“Every health care system has limits,” Bogoch says. “The question is, if we start getting inundated with cases, how stretched can we get?”
Many emergency-room doctors argue Canada’s ERs are already as stretched as they can get and are worried about what would happen if they suddenly had to start treating COVID-19 cases en masse.
From the public-health perspective, the greatest challenge may be as simple communicating across all parts of the health system across the country, said Dr. Jasmine Pawa, president of the Public Health Physicians of Canada.
“We cover a very wide geographic area,” she said, though she added that Canada has made great strides over the course of the SARS experience and the H1N1 flu outbreak in 2009.
Dr. Alan Drummond of the Canadian Association of Emergency Physicians, who works at the hospital in Perth, Ont., says he doesn’t want to fearmonger, especially considering all the lessons Canada has learned from past outbreaks, but the reality of life in the ER gives him pause.
“Our day-to-day experience in crowded hospitals, unable to get the right patient in the right bed on a day-to-day basis … makes us really question what the integrity of our health-care system would be like in a major severe pandemic,” Drummond says.
He envisions that a disease like COVID-19, if it spread widely, would have a major impact, including the possibility of cancelled surgeries and moving stable patients out of hospitals who would otherwise stay.
“I think there would have to be hard decisions made about who lives and who dies, given our limited availability by both speciality and (intensive-care) beds and we would probably see some degree of health-care rationing,” he says.
The problem may be even more pronounced because of Canada’s aging population, he said. The virus tends to hit older people harder, according to observations made in China and abroad, and is also particularly dangerous for people with other health problems.
Older people also tend to stay admitted in hospital beds even when they are in relatively stable condition because of a lack of long-term-care beds across the country.
That keeps emergency rooms from being able to move acute patients out of the ER and into those beds, limiting hospitals’ capacity to handle new cases.
Tam agreed Friday that hospital capacity is a “critical aspect” of Canada’s preparedness for a potential coronavirus outbreak, but said even very bad flu seasons can have a similar effect on emergency rooms.
“If we can delay the impact of the coronavirus until a certain period, when there’s less influenza for example, that would also be very helpful,” she said.
She also suggested people who are concerned about the possibility that they’re developing COVID-19 symptoms should call ahead to a hospital so they can make proper arrangements for containment and isolation.
Canada is doing its best, along with every other country in the world, to seize this time of relative containment and plan ahead, Tam said.
Laura Osman, The Canadian Press
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