The SARS-CoV-2/COVID-19 coronavirus

[madd0ct0r]

Seems worth having a thread.

From the BBC

What do we know about the virus?
Currently known as 2019-nCoV, the virus is understood to be a new strain of coronavirus not previously identified in humans. The Sars (Severe Acute Respiratory Syndrome) virus that killed nearly 800 people globally in the early 2000s was also a coronavirus, as is the common cold.


Video captionThe BBC's online health editor talks us through what we know about the virus
Authorities have said this new virus originated in a seafood market in Wuhan that "conducted illegal transactions of wild animals".

There is evidence of human-to-human transmission, with the virus spreading from patients to family members and healthcare workers.

The virus infects the lungs, and symptoms start with a fever and cough. It can progress to shortness of breath and breathing difficulties.

There is no vaccine as yet, though three research teams are working on one.

line
Why is this not a global emergency?
Analysis by James Gallagher, BBC health and science correspondent

The view of the WHO's emergency committee was "now is not the time". Two reasons were cited: the limited number of cases abroad and the "efforts made by China".

The latter seems to be a nod to the lockdown of multiple cities in the past 24 hours, which should minimise the risk of the virus becoming a global problem. But it may yet become one.

Some scientific details were also released, with the WHO saying 25% of reported cases were developing severe symptoms.

And there were two clues on how infectious the novel coronavirus is.

There is a preliminary estimate of the average number of people each infected person passes the virus on to (known as the R0 value) of between 1.4 and 2.5.

Any number greater than one means the virus has the potential to spread in the population, but this is lower than the figure for Sars.

[aerius]

Just got off the phone with my parents who are over in Asia. There's now over 40 million people under "quarantine", I say that because they're not really stopping people from leaving. What they've done is cut off trains, buses, and other public transportation into & out of the areas, cars & people are still going in & out. So basically, an infected person could still drive out of town, hop on a plane and spread the infection overseas.

Last count there were 900+ confirmed cases and about 30 deaths, so death rate seems to be in the 3% range.

Also, there's rumours that this was something which accidentally got out of the Wuhan Virus Research lab. Probably put that in the tinfoil category for now, but it's something to keep in mind.

[Bedlam]

The death rate may be lower than it seems depending on the number, if any, infected individuals who don't show significant symptoms. Unless you test everybody in an area that's always an unknown.

From what I've heard so far the profile of the fatalities matches that for seasonal flu, i.e. those who are dying are tending to be the young, old or already weakened in some way.

[LadyTevar]

UPDATE!
Chicago woman in her 60s now diagnosed after returning home from visiting relatives in Wuhan.

There are 63 patients in 22 US states being monitored for signs of the rare respiratory illness, US officials say.

[LadyTevar]

Wuhan, where the outbreak began, is rapidly building a new hospital.

The city - home to around 11 million people - is struggling to cope with the increasing number of patients.

Chinese media outlets said the 1,000-bed hospital could be ready within six days. A total of 35 diggers and 10 bulldozers are currently working on the site.

The project will "solve the shortage of existing medical resources" and would be "built fast [and] not cost much... because it will be prefabricated buildings", the outlet said.

[LadyTevar]

Oh. FUCK.

Analysis - A worrying development?
We have a crucial new piece of information - people with no symptoms of infection may be able to spread the virus.

Scientists in China have published detailed information, in the Lancet medical journal, on the first cases in the country.

It includes information on a child with no outward symptoms, but a clear coronavirus infection in their lungs.

Prof Kwok-Yung Yuen from the University of Hong Kong-Shenzhen Hospital said "asymptomatic infection appears possible".

How often or easily this happens is far from clear, but it could make the virus far harder to contain.

Prof Yuen said if this was the case, then controlling the epidemic would rely on isolating patients and quarantining anyone they came into contact with "as early as possible".

Researchers also said the new virus was closely related to one found in Chinese horseshoe bats. (bolding mine)

It was said the first cases were reported in people who were at a live market for fish and "game". Is there a market for bat?

[mr friendly guy]

The death rate may be lower than it seems depending on the number, if any, infected individuals who don't show significant symptoms. Unless you test everybody in an area that's always an unknown.

From what I've heard so far the profile of the fatalities matches that for seasonal flu, i.e. those who are dying are tending to be the young, old or already weakened in some way.

Pretty much from what I heard. The death toll so far is much lower than say flu in the US over one month during flu season. The problem is we don't know that much about it, so it could be a bigger problem.

Wuhan, where the outbreak began, is rapidly building a new hospital.

The city - home to around 11 million people - is struggling to cope with the increasing number of patients.

Chinese media outlets said the 1,000-bed hospital could be ready within six days. A total of 35 diggers and 10 bulldozers are currently working on the site.

The project will "solve the shortage of existing medical resources" and would be "built fast [and] not cost much... because it will be prefabricated buildings", the outlet said.

That's what they did to combat SARS. Only this time they are most probably doing it much earlier into the outbreak based on experience with dealing with SARS.

Also it doesn't have to have a market for bats. MERS was also a bat virus which spread to another animal (camels) before going to humans.

Also, there's rumours that this was something which accidentally got out of the Wuhan Virus Research lab. Probably put that in the tinfoil category for now, but it's something to keep in mind.

Tinfoil hat types also said that for SARS. The phenomena of virus crossing species or mixing its genetic code with human viruses to make a new one is well known to science. An example of outside China of this happening is MERS.

[Broomstick]

Chicago woman in her 60s now diagnosed after returning home from visiting relatives in Wuhan.

In other words, the passenger screening at O'Hare actually works. While an ill traveler is a bad sign, the fact she was identified as such is a good sign.

Symptomatic travelers are now turning up world-wide, which should surprise no one given that international travel has never been easier in history. But, as I said, ill/exposed travelers identified at airports indicate that the screening measures are working. It also helps that the Chinese rapidly identified this virus and have freely disseminated the information needed to quickly identify it to everyone. This is the opposite of the the secrecy the used during the SARS outbreak.

[mr friendly guy]

According to Chinese news, they have now produced a rapid detection PCR kit for this particular virus which takes 1 hour to identify the disease. The beauty is that these kits can be mass produced. That is quick.

[ray245]

It's funny to see a Guardian reporter going to Wuhan and try and make a big deal about the streets being quiet and etc.

It's Chinese New Year! Shops are shut just like how shops are shut during Christmas in Western countries. It's really funny how western media continues to lack of the context to understand and frame stories about China.

[MKSheppard]

It's really funny how western media continues to lack of the context to understand and frame stories about China.

I don't know; when Comrade Winnie the Pooh says that China is facing a "grave situation" and they're cancelling major lunar years stuff, like the huge massive show that gets shown on CCTV each year....

You should sit up and take notice.

[ray245]

It's really funny how western media continues to lack of the context to understand and frame stories about China.

I don't know; when Comrade Winnie the Pooh says that China is facing a "grave situation" and they're cancelling major lunar years stuff, like the huge massive show that gets shown on CCTV each year....

You should sit up and take notice.

Yes it is serious. But deserted streets would have happened irregardless of a virus outbreak.

Shops aren't shut because of the outbreak. Shops are shut because it's the holiday season in China anyway. Imagine if a Chinese reporter goes around the US in the middle of an epidemic outbreak in the US right on the Christmas season and Christmas day itself, and pointing out how quiet the streets are.

You can discuss about how serious and dramatic the situation is, while at the same time giving people a good context of situation on the ground. If shops are going to be closed anyway even if there is no epidemic, then it's really not something to report about, and it might paint a false picture of things.

Things is going really badly, but it's still not as badly to the extend it's the end of the world in Wuhan.

[LadyTevar]

China coronavirus 'spreads before symptoms show'

A new coronavirus that has spread to almost 2,000 people is infectious in its incubation period - before symptoms show - making it harder to contain, Chinese officials say.

Some 56 people have died from the virus. Health minister Ma Xiaowei told reporters the ability of the virus to spread appeared to be strengthening.

Several Chinese cities have imposed significant travel restrictions.

Wuhan in Hubei, the source of the outbreak, is in effective lockdown.

The infections were at a "crucial stage of containment", Ma Xiaowei said.

Officials announced that the sale of all wildlife in China would be banned from Sunday. The virus is thought to have originated in animals, but no cause has been officially identified.

In humans, the incubation period - during which a person has the disease, but no symptoms yet - ranges from between one and 14 days, officials believe.

Without symptoms, a person may not know they have the infection, but still be able to spread it.

This is a significant development in our understanding of the virus and the lengths China will have to go to stop it.

People with Sars (the last deadly coronavirus outbreak to hit China) and Ebola are contagious only when symptoms appear.

Such outbreaks are relatively easy to stop - identify and isolate people who are sick and monitor anyone they came into contact with.

Flu, however, is the most famous example of a virus that you spread before you even know you're ill.

We are not at the stage where people are saying this could be a global pandemic like swine flu.

But stopping such "symptomless spreaders" will make the job of the Chinese authorities much harder.

There are still crucial questions - how infectious are people during the incubation period and did any of the patients outside China spread the disease in those countries before becoming sick?

And why did China's National Health Commission say the transmission ability of this virus is getting stronger?

[Broomstick]

I think it more likely that the CNHC said "the transmission ability of this virus is stronger than we thought" rather than saying it's getting stronger, but I'm not a speaker of any Asian language so I might be wrong on that.

If this spreads before symptoms show up then the quarantine(s) will have to be more stringent, and since it's already gotten off the Asian continent that might mean quarantines in other areas. Yeah, that could be a problem....

Fatalities are, last I heard, still around 3%. That's not great. That's higher percentage than garden-variety flu. On the other hand, it's less than the SARS virus and several other examples. Even if it went to global pandemic - which I hope it doesn't - if the fatality rate is that low it would be ugly but it wouldn't mean the end of the world as we know it.

[aerius]

My Chinese is really rusty but if what she's saying in the video is true then it's like 50 times worse than the official numbers. As of the 24th when the video was posted, there's 90,000 cases and if an infected person isn't treated he'll spread it to 14 people. Someone with better Chinese than me can translate the rest, but it definitely sounds worse than the official reports.

[mr friendly guy]

I saw this on a reddit post and the consensus its fake across Chinese social media. The things to look out for is the accent is not a Wuhan accent. To be fair, I can't tell what a Wuhan accent sounds like, but you can find videos comparing different accents from parts of China.
https://www.youtube.com/watch?v=BcbAV7PJN_c (Wuhan accent is at 0.58).

However as someone who has worked in operating theatres before, I can recognise scrub hats. The person is wearing a swimming cap dude, which funny enough is another reason people are calling it fake.

Buzzfeed has compiled some list of fake claims, including the infamous women eating bat on television (turns out to be eaten in Palau and it occurred 4 years ago).
https://www.buzzfeednews.com/article/ja ... ion-spread

[Ralin]

The President of the United States of America has praised China for their efforts to contain the coronavirus.

My first reaction was that this was a rare case of Trump being right about something. Then I gradually realized that maybe we should take this as a sign that things are a lot worse than they're being made out to be.

[madd0ct0r]

The President of the United States of America has praised China for their efforts to contain the coronavirus.

My first reaction was that this was a rare case of Trump being right about something. Then I gradually realized that maybe we should take this as a sign that things are a lot worse than they're being made out to be.

It's a great distraction from Brexit/impeachment with a strain of anti outsider sentiment that suits both too.
People are literally still dying of ebola but when was that last news?

[The Romulan Republic]

The President of the United States of America has praised China for their efforts to contain the coronavirus.

My first reaction was that this was a rare case of Trump being right about something. Then I gradually realized that maybe we should take this as a sign that things are a lot worse than they're being made out to be.

I mean, its technically possible that Trump said something that isn't full of shit, but...

[LadyTevar]

Coronavirus: Death toll rises as virus spreads to every Chinese region

The death toll of the coronavirus has risen to 170 and with a confirmed case in Tibet, the virus has now spread to every region in mainland China.

Chinese health authorities have said there were 7,711 confirmed cases in the country as of 29 January.

Infections have also spread to at least 16 other countries.

The World Health Organization (WHO) will meet on Thursday to discuss whether the virus constitutes a global health emergency.

"In the last few days the progress of the virus, especially in some countries, especially human-to-human transmission, worries us," WHO Director-General Tedros Adhanom Ghebreyesus said on Wednesday, pointing to Germany, Vietnam and Japan.

"Although the numbers outside China are still relatively small, they hold the potential for a much larger outbreak."

More here

[LadyTevar]

Two hundred Americans to face quarantine in California

Some 200 US citizens are due to be quarantined in California after arriving from Wuhan, China amid the coronavirus oubreak.

The passengers, mostly diplomats, were evacuated via a chartered flight that landed on US soil on Wednesday.

They will be quarantined for at least 72 hours, but could be kept isolated for up to two weeks if they have any symptoms, officials said.

The flight landed at a US air base near Riverside, California.

Earlier, the flight stopped in Anchorage, Alaska, to refuel while the 201 were given an initial screen for symptoms. None exhibited any signs of the coronavirus, according to the state's chief medical officer. Five cases of coronavirus have been confirmed in the US as of Tuesday.

The Department of State, which chartered the flight, said places aboard were offered to government workers, with unfilled seats sold to US citizens on a "reimbursable basis", though it was unclear if the agency was offering to pay back the reported $1,000 per ticket cost.

It was originally scheduled to land at the civilian Ontario International Airport, some 30 miles (48km) from Los Angeles, but was diverted to the March Air Reserve military base.

The Ontario airport had prepared for the arrival of the chartered flight on Tuesday by setting up showers, bathrooms and beds in a hangar. The decision to move the flight to the air base came that evening.

The switch was made for logistical reasons, Curt Hagman, a San Bernardino county official said.

Mr Hagman had earlier said passengers could be quarantined for up to two weeks.

The US Department of Defence said they will work with Health and Human Services officials to care for the evacuees. Any passengers who fall ill will be transported to a civilian hospital.

Alex Azar, the US Health and Human Services secretary, said: "Americans should know that this is a potentially very serious public health threat."

The CDC will be carrying out screenings at 20 commercial airports.

As the severity of the outbreak deepens, the White House is considering temporarily banning flights from China, US media report.

The UK, Australia, Japan and EU nations have also been repatriating citizens.

The virus has caused more than 130 deaths, spreading across China and to at least 16 other countries.

During the 2003 global Severe Acute Respiratory Syndrome (SARS) outbreak, US patients were isolated to contain the spread, but as there was limited transmission in the country, there was no population-based quarantine, according to the CDC.

In 2014, fears over Ebola prompted a number of US states to impose quarantine policies.

[The Romulan Republic]

A 72 hour quarantine for something that may not show symptoms for considerably longer than that? Well that's rather useless, isn't it?

Here's a rundown on the current situation:

https://bbc.com/news/world-asia-china-51299195

The "whole world needs to be on alert" to fight the coronavirus, the head of the World Health Organization's Health Emergencies Programme has said.

Dr Mike Ryan praised China's response to the deadly outbreak, saying: "The challenge is great but the response has been massive."

The WHO will meet on Thursday to discuss whether the virus constitutes a global health emergency.

The Chinese city of Wuhan is the epicentre of the outbreak.

But the virus has spread across China and to at least 16 countries globally, including Thailand, France, the US and Australia.

More than 130 people have died in China and close to 6,000 have been infected.

There is no specific cure or vaccine. A number of people have recovered after treatment, however.

The WHO's Dr Ryan said an international team of experts was being assembled to go to China and work with experts there to learn more about how the disease is transmitted.

"We are at an important juncture in this event. We believe these chains of transmission can still be interrupted," he said.

Scientists in Australia have managed to recreate the new coronavirus outside of China, raising hope that it could be used to develop an early-diagnosis test.

WHO director-general Tedros Adhanom Ghebreyesus, who visited China this week, said most people who contracted the virus were suffering only "milder symptoms", but about 20% had severe effects such as pneumonia and respiratory failure.

He said that China "needs the world's solidarity and support," and that "the world is pulling together to end the outbreak, building on lessons learned from past outbreaks."

The director-general added that the WHO "deeply regrets" referring to the worldwide risk from the virus as "moderate" in three reports last week instead of "high".

He described the person-to-person spread of the illness in Germany, Vietnam and Japan as worrying, and said experts would consider it on Thursday when deciding whether to declare a global emergency.

What's happening in Wuhan?

The city's residents are enduring an isolated, frightening time. Most forms of traffic have been banned, and 11 million people are shut up in their homes, trying to minimise the spread of the virus.

Wuhan people cry out 'stay strong' from windows

Videos have emerged online of neighbours shouting "Wuhan jiayou!" out of their windows - roughly translated to "Stay strong Wuhan!" or "Keep on going Wuhan".

The phrase has been trending on Weibo, China's Twitter-like social media site, with people from around the country posting supportive messages.

"We will get through this. Wuhan jiayou, the whole country is supporting you," read one comment on Weibo.

"This is the first day since the lockdown that I've had to go out," a man in his 50s told the AFP news agency on Wednesday, on a mostly-deserted street.

"I have no choice because I need to buy food."

Analysis - Why don't we know the death rate?

By James Gallagher, BBC health and science correspondent

How deadly is this virus? It is a basic question, but the answer is elusive.

It is far too simplistic to take the 130 deaths and the 6,000 cases and come up with a death rate of 2%.

We're in the middle of the outbreak and thousands of those patients are still being treated.

We don't know if they will live or die, so they can't be used in these calculations.

We also don't know how many mild and undetected cases are out there.

"It is very early to make any statements on what the overall mortality rate may be," the WHO's Maria Van Kerkhove has warned.

Also, the deadliness of the new virus is only one component of its threat.

Flu kills hundreds of thousands of people each year not because it is super-deadly, but because it is able to infect so many people.

Who is being evacuated from Wuhan?

Hundreds of foreign nationals are being evacuated from Wuhan, where the virus first emerged, with Japan, the US and the EU among those repatriating their citizens.

Some 200 Japanese nationals have landed at Tokyo's Haneda airport, and 240 Americans - including workers from the local US consulate - left Wuhan on Wednesday.

The US flight landed at a California military base and was met on the tarmac by emergency vehicles. The defense department said those on board would be monitored and sent to local hospitals if they fell ill.

Australia plans to quarantine its evacuees on Christmas island, 2,000km (1,200 miles) from the mainland.

Two aircraft to fly EU citizens home have been scheduled, with 250 French nationals leaving on the first flight.

South Korea said some 700 of its citizens would leave on four flights this week. Both Malaysia and the Philippines have also pledged to evacuate their citizens in and around Wuhan.

Canada has chartered a plane to bring home around 160 of its nationals, but said it could take several days to get permission to land near Wuhan.

What's the travel situation?

On Tuesday, Hong Kong announced plans to slash cross-border travel between the city and mainland China.

British Airways has suspended all flights to and from the Chinese mainland, and the UK's Foreign Office warned against "all but essential travel" there.

Several other airlines have taken similar measures. United Airlines and Cathay Pacific are restricting flights, while Lion Air - one of Asia's biggest airlines - is stopping flights to China from Saturday.

Cathay Pacific has also suspended in-flight trolley services, changed some aspects of its meal offer, and stopped giving out hot towels, pillows, blankets and magazines in an effort to prevent the virus spreading.

[Broomstick]

At this point I'm expecting both the number of infections and number of deceased to keep rising for at least a couple weeks, because that's how these things work.

Not sure if the genie is still in the bottle or not.

And, of course, anyone brought out of China to their home country could and should be quarantined. Not sure I understand the "just three days" thing with the US group - while I've heard that once they return home they'll continued to be monitored I'm not sure that's really the best course. Yes, I know, keeping people confined for a couple weeks is annoying, awkward, difficult, and costs money, but it might be a lot more effective than what's being proposed.

[Ralin]

A 72 hour quarantine for something that may not show symptoms for considerably longer than that? Well that's rather useless, isn't it?

I mean, it's more than nothing. And this is America. No one wants to pay for a 2+ week hospital stay, and there are limits to the government's ability to just tell people they have to.

[Broomstick]

Chicago has its second case of Wuhan virus, this time human-to-human transmission. More specifically, the husband of the first case has come down with it.

I'll also point out that if your quarantining people who are not yet showing symptoms you don't have to confine them in a hospital. You can put them up at a hotel, or even basically put them under house arrest which would be even cheaper.