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The 3 main ways Coronavirus Spreads



As the number of cases of coronavirus COVID-19 grows worldwide, the US CDC has detailed the primary ways in which the SARS-like illness could be spread, and which routes it is most concerned with. The first person-to-person infection in the US was confirmed at the end of January 2020, and since then the US Centers for Disease Control and Prevention have held several briefings to outline exactly what people should – and shouldn’t – be worried about.

One of the most pressing questions is the mechanisms of just how that person-to-person spread might take place. COVID-19 has a roughly fourteen day incubation period, and one of the challenges that healthcare providers face is that, if tested too early, the current tests for the infection can return a false-negative.

“Based on what we know now, we believe this virus spreads mainly from person to person, among close contact, which is defined as about six feet, through respiratory droplets produced when an infected person coughs or sneezes,” Nancy Messonnier, M.D., Director at the National Center for Immunization and Respiratory Diseases said today during a CDC briefing. “People are thought to be most contagious when they are most symptomatic: that is, when they are the sickest.”

There are, however, two other ways by which coronavirus could be transmitted. “Some spread may happen by touching contaminated surfaces and then touching the eyes, nose, and mouth,” Dr Messonnier added. “But remember, we believe that this virus does not last long on surfaces. Some spread may happen before people show symptoms. There have been a few reports of this with the new coronavirus, and it is compatible with what we know about other respiratory viruses, including seasonal flu.”

In reality, it’s coughing and sneezing that is the primary concern. “Right now, we do not believe these last two forms of transmission are the main driver of spread,” Dr Messonnier said.

Disease surveillance is ramping up in response

Five public health labs around the US have already been brought online to add COVID-19 surveillance to their existing work. “We are looking at existing surveillance systems both for influenza and for respiratory diseases,” Dr Messonnier explained. “Results from this surveillance would be an early-warning signal to trigger a change in our response strategy.”

The fear is that, while not currently an issue, coronavirus contagion could become more widespread. Although not guaranteed, that’s something the CDC and other agencies are getting ready for. “We must prepare for the possibility that at some point we may see sustained community spread in other countries, or in the US, and this will trigger a change in our response strategy,” Dr Messonnier said.

The current public health labs are in Los Angeles, San Francisco, Seattle, Chicago, and New York City. “This is just the starting point, and we plan to expand to more sites in the comping weeks until we have national surveillance,” the NCIRD director confirmed.

A testing delay

One of the biggest steps taken already was to expand testing of potentially-infected samples, using a fast-tracked coronavirus assessment. That hit a snag recently, when reports from external labs indicated non-conclusive results were being produced. Investigations by those labs and the CDCs identified problems in the reagents being used as part of the test.

The CDC is currently reformulating those reagents, Dr Messonnier confirmed, though there’s no timescale for when they might be ready for redeployment.

Meanwhile, however, the biggest risk for most people still isn’t COVID-19 at all. H1N1, aka Influenza A, has seen a sudden rise in numbers of infections in the US this season, in line with 2018’s “severe” rating. So far there have been 250,000 hospitalizations, and 14,000 deaths.

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B.C.'s new coronavirus case is woman who recently returned from Iran – CTV News



Another person in British Columbia has tested positive for the novel coronavirus known as COVID-19, provincial health officials announced Thursday.

The case is a “presumptive positive” and a sample has been sent to the National Microbiology Lab in Winnipeg for confirmation.

Minister of Health Adrian Dix and Provincial Health Officer Dr. Bonnie Henry announced the case to reporters at the provincial legislature a day earlier than their regularly scheduled update on the virus.

The case is a woman in her 30s who resides in the Fraser Health region, Henry said. The woman recently returned from travel to Iran and has a milder form of the disease, Henry said.

The province’s top doctor said Fraser Health has already begun investigating the woman’s close contacts and placed a number of the people she’s been in close proximity to in isolation.

“We’ll be doing a detailed investigation of her travel, when her symptoms started, and determine whether we need to investigate or notify people who were on the aircraft she returned in,” Henry said.

The new case brings the total number recorded in British Columbia to six. On Wednesday, the province announced that the first person in B.C. to contract the virus had recovered.

Henry said the provincial government still believes the risk to British Columbians from the COVID-19 is low.

“I think this reflects that we have a very robust system for picking up people who may have this virus,” Henry said. “This one, clearly, is a bit unusual in that the travel to Iran is something new.”

Iran recently began reporting cases of the virus, Henry said. She said provincial health officials will be working with Canadian and international health organizations to determine where the woman contracted the virus.  

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WHO says no time for complacency as China coronavirus cases fall – Reuters



GENEVA/LONDON (Reuters) – A continued decline in the number of new cases of coronavirus infections in China is encouraging, the World Health Organization (WHO) said on Thursday, while warning that infections outside the country could still spread.

FILE PHOTO: Director-General of the WHO Tedros Adhanom Ghebreyesus, attends a news conference on the novel coronavirus (2019-nCoV) in Geneva, Switzerland February 11, 2020. REUTERS/Denis Balibouse

“We are encouraged by this trend but this is no time for complacency,” the WHO’s director-general, Tedros Adhanom Ghebreyesus, told a briefing in Geneva.

To date, 25 other countries have reported 1,076 cases to WHO, including five in the latest affected, Iran, he said.

Tedros noted that the total was very low compared with nearly 75,000 inside China, but added: “That may not stay the same for long”.

The mayor of Daegu, South Korea’s fourth-largest city, urged residents to stay indoors after a spike in infections linked to a church congregation.

The latest cases reported by South Korea are from “several distinct clusters”, Oliver Morgan, the WHO’s director of health emergency information and risk assessment, told the briefing.

“So although the number seems quite high, they are mostly linked to known existing outbreaks,” Morgan said.

“That doesn’t signal a particular change in global epidemiology but it does signal that the Korean authorities are following up very closely, very vigorously, on all the new cases and those outbreaks that they have identified.”

Tedros, noting that South Korean authorities have reported a total of 104 confirmed cases, including 22 on Thursday, said: “With measures they can take, which is proportionate to the public health risk they have, I think the number of cases are really manageable.”

He also said that he had contacted 12 leading manufacturers of protective equipment – such as masks, goggles and gowns – to ensure that health workers received supplies first, adding that he had received a “positive signal”.

Chen Xu, China’s ambassador to the United Nations in Geneva, said he had discussed such medical shortages with Tedros. “Indeed we need definitely masks and protection units and also respiratory machines,” Chen told a separate news conference.

A WHO-led international mission now in China – which Chen described as a “joint venture” – was visiting several provinces and a stop in the outbreak’s epicenter, Wuhan, a city in Hubei province, was “under consideration”, he said.

“If the experts visit other provinces without going to Wuhan they couldn’t have the first-hand knowledge. While in the meantime, it is really risky to go to Wuhan because of the spread of the virus and because of the quarantine needed afterwards,” Chen said. “I think the picture will be very much clearer in the days to come.”

Reporting by Stephanie Nebehay in Geneva and Kate Kelland in London; Editing by Mark Heinrich and Jonathan Oatis

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Coquitlam grandmother among Tri-City group to be evacuated from coronavirus cruise ship – The Tri-City News



A group of Tri-City residents are among the 250 Canadians aboard the Diamond Princess cruise ship, which has spent two weeks under quarantine in Japan following the novel coronavirus outbreak.

Margaret Tong, an 85-year-old Coquitlam resident, is one of the travellers who will be returning to Canada Friday on a government-chartered flight but her trip is still far from over. The plane is expected to land in Cornwall, Ont., where passengers will be taken to a hotel and kept in isolation for another 14 days.

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“Thanks for your prayers and good wishes,” Tong said in a WhatsApp message to her son, Brian Tong, Wednesday night. “Passed the Canadian medical screening. Packing to disembark tonight at 9 p.m. Will contact you upon arrival at Cornwall Ontario.”

In an interview with The Tri-City News, Brian Tong said his mom left Vancouver Jan. 18 and was supposed to be home within two weeks. He said information was limited but thankfully his mother had the internet and was able to communicate with him throughout the ordeal.

“The [Japanese] government was very slow in decision making on what to do,” he said, noting his mother was traveling with a group of people from the area, “so it was many days of uncertainty while the head count of the infected kept rising.”

The good news is that Margaret Tong has been tested and does not appear to have been affected by the virus, her son said. Thermometers were handed out on the ship and anyone who registered a temperature of 37.5 C or higher was asked to go to the medical centre, he said.

“She was always below 36.5,” he said.

Despite the upheaval, Brian Tong added that he “wasn’t too worried” about his mother, who is active, works out regularly at Coquitlam’s City Centre Aquatic Complex and has a strong immune system.

“Of the people affected, there have been very few fatalities,” Brian Tong told The Tri-City News, adding, “My mother goes to the gym six times a week.”

His bigger concern is getting his mom her medication, which she was running short of during the quarantine period.

“I told her that the Japanese government is responsible for them and they have to top up whoever needs medication,” he said. “They were able to do that.”

The chartered Canadian flight was expected to take off from Japan at 3:30 a.m local time and land at CFB Trenton at around 1:30 a.m. EST Friday.

There, further screening will be conducted and another two-week quarantine will be imposed. But federal Health Minister Patty Hajdu said there is a chance those who test negative for the virus and show no signs of symptoms may be released from quarantine early under the discretion of Canada’s top public-health doctor.

Forty-seven of the 250 Canadians will not be on the flight, after testing positive for the virus. They will continue their treatment in Japan.

Two people have died aboard the ship; a man and a woman, both from Japan and in their 80s, were believed to have been infected before the quarantine began, according to Japanese health officials.

– with files from the Canadian Press

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