As you may know, a novel coronavirus outbreak has swept the country of China with cases reaching every corner of the globe. Like previous outbreaks, this strain of virus has never before been seen in humans therefore no effective treatment or vaccine has been developed. As of today many countries, especially in Asia, have issued travel restrictions and quarantine measures to prevent further infection in the general public.
How did this outbreak start?
The epicenter of the novel coronavirus is reported as the seafood market in Wuhan, China (giving this strain the informal name “Wuhan Coronavirus.)
Wuhan is a city of just over 11 million people- making it more populous and densely packed than New York City. It sits as the capital of the Hubei province which is home to more than 50 million people. Wuhan is known to be a center for production of goods shipped worldwide and is a transportation hub for all of central China (much in the same way Chicago is for the United States.) In addition to production and transportation, Wuhan is an industrious tech city with research parks and technology company headquarters numbering in the thousands. While advanced, the city is still home to numerous blue collar workers, many of whom shop at markets such as the one where this outbreak began.
The seafood market is well known to have a thriving black market where animals such as rabbits, ducks, dogs, marmots, snakes, and bats are traded and sold as food illegally. In the past coronavirus strains have been known to make the jump from animals to humans- in fact this is what happened in the 2003 SARS outbreak that killed over 700 people and infected over 8,000.
The World Health Organization (WHO) alongside Chinese Center for Disease Control originally thought this particular viral strain came from snakes, however more recent study shows the likely culprit was actually infected bats.
The first case of Coronavirus was reported officially on December 31st, sparking a shutdown and cleaning of the Wuhan Seafood Market on January 1st- little did authorities know this measure would prove to be too little too late.
Within a few weeks the number of cases reported in the Hubei province soared to over 1000, causing the Chinese government to extend the Chinese New Year holiday and suspend travel for millions.
What is the Coronavirus?
Coronaviruses are a family of viral strains known to cause infections both seasonally and in the form of an epidemic among populations. They are similar to flu strains in how they adapt and can jump species (like the swine flu aka H1N1.) In fact, it is a virus in the coronavirus that caused the SARS outbreak of 2003- and a strain of coronavirus that causes the common cold. This is important to note because while the name “coronavirus” may be new to many, it is not necessarily indicative of the severity of this specific outbreak.
This particular Coronavirus seems to have the same features as the SARS outbreak in that it originally came from animals (bats in this case) and can be transmitted person to person both airborne and by touch. This means protective gear must be more than simple surgical coverings- including more advanced masks to prevent further infection.
This particular strain is currently responsible for more than 40,500 infections officially reported, likely with numbers soaring well over 50,000 by the time the outbreak peaks. The majority of those infected are in China with fewer than 1,000 receiving treatment in other countries (though cases have reached more than 30 countries all over the world.)
By the numbers:
Currently Infected: 40,660
Countries reporting infection:
- China: 40,199
- Japan: 161
- Singapore: 45
- Hong Kong: 42
- Thailand: 32
- South Korea: 27
- Malaysia: 18
- Taiwan: 18
- Australia: 15
- Vietnam: 14
- Germany: 14
- United States: 12
- France: 11
- Macao: 10
- United Arab Emirates: 8
- United Kingdom: 8
- Canada: 7
- Philippines: 3
- Italy: 3
- India: 3
- Russia: 2
- Spain: 2
- Sweden: 1
- Sri Lanka: 1
- Cambodia: 1
- Nepal: 1
- Finland: 1
- Belgium: 1
What are the symptoms of this Coronavirus?
According to the U.S. Center for Disease Control the main symptoms of this novel coronavirus include fever, cough, and shortness of breath.
Symptoms of the infection may appear in as little as 48 hours after exposure all the way up to 14 days after exposure. The virus is contagious even before symptoms appear meaning most people are exposed to the coronavirus without knowing- and most people who are spreading the virus are also unaware of their infected status.
This particular strain is notable for causing pneumonia, kidney failure, and liver failure in severely infected patients accounting for a death toll of nearly 1000 so far.
How deadly is this virus?
Currently it has been reported that nearly 8% of those infected have been cured completely, and fewer than 2% of those infected have died from complications. Because the outbreak is still in such an early stage and the incubation and infection periods are both long in comparison to other viruses the exact figures are nearly impossible to calculate.
It is known that this strain is likely not as dangerous as many flu strains, and has responded to some treatments of the antiviral drug known as interferon when administered in the hospital setting, however treatment of this kind of virus is often tricky and supplies of effective drugs are low in the places most affected by the outbreak.
While the virus itself may not be particularly deadly it seems to be highly transmissible with each positive case infecting an average of 3-4 people (compared to the SARS outbreak where positive cases infected an average of 1-2 people) making this strain much more difficult to contain.
What has been done to contain the virus?
The Chinese government took swift action in creating quarantined areas and issuing travel bans between regions. Transportation was quickly halted and supplies were rerouted to keep medical workers and officials safe in the midst of the outbreak. Because of the swift action most public panic was avoided, however several instances of police brutality and censorship have been recorded since early January.
Construction of two new specialty facilities to relieve overcrowded hospitals began in late January, with one reaching completion as of February 7th. New hospital capacity numbers over 2,600 however supplies and medical staff are in greater shortage than beds at this stage.
Government officials have instituted a state of emergency self quarantine calling for all families to remain in their homes except for required supply trips to grocery stores. Most businesses have been shut down and checkpoints have been issued on roadways to measure temperatures of those out and about.
In addition to checkpoints, store entrances are scanning temperatures and asking about symptoms before admittance.
The dire state.
Businesses in China have been shut down for weeks now, halting production of international goods, and threatening to send the Chinese economy (which is currently responsible for 16% of worldwide economic activity) into a tailspin.
Grocery prices have steadily increased, especially in central provinces like Hubei, due to transportation halts and production stoppage. Concern over grocery prices and expected increases has created a call for institutionally set prices and rations should the self quarantine requirements continue much longer.
Hospitals are desperate for safety measures as many are reporting shortages in surgical equipment, protective clothing, masks, gloves, testing supplies, and medication suitable for treatment. Currently patients who show symptoms of coronavirus must wait nearly 4 days to receive positive or negative test results, and during that time they are held in wards where many other infected people are receiving treatment causing faster spread within hospitals and further shortages.
Healthcare workers are desperate for breaks and protection with pictures emerging of nurses and doctors sleeping in their hazmat suits because they know if they remove that suit there won’t be another to keep them safe on their next shift- which may be in as few as 4 short hours. With these vital workers facing horrifying levels of exhaustion in increasingly strenuous circumstances the instance rate of nurses and doctors becoming infected has outpaced that of standard citizens by over 100%.
The World Health Organization has increased assistance with aid workers as well as providing supplies and tracking transmission in order to best protect healthcare workers and the public- as well as to predict future needs. Latest estimates claim over 50,000 positive cases with an expected death toll in the thousands.
Traveling to and from China:
Currently travel to China is not advised. The country has implemented safety measures to quarantine the virus nationwide- including their bustling population center of Shanghai which is home to more than 24 million people.
All people in China (citizens or not) are advised to stay in their homes as much as possible, only venturing out for required supplies- and advised to wear masks to protect them when they do. Police, especially in Wuhan, have been in a state of emergency in order to attempt to further contain the outbreak.
Transportation to and from Wuhan has been all but suspended with very few trains and flights into and out of the city.
Consulates from countries all around the world have been shut down in the midst of the outbreak, and many countries including the United States have chartered specific evacuation flights for key citizens stuck in the outbreak.
Currently, except for evacuations organized by governments, no evacuations are allowed.
Because China acts as such a strong transportation hub for worldwide flights many travelers have been affected by rerouting and cancellations. The severity of the outbreak has led many airlines to instead direct flights to nearby Japan, Korea, Thailand, or the Philippines. This has led to delays of currently scheduled flights to and from those hubs as well, trickling into flights all across the globe.
Many visas into and out of countries around China have been suspended with travel only permitted on behalf of multinational companies- thus stranding students and leisure travelers without an escape. Before February 7th regional countries were simply instating a 14 day self quarantine, however with the escalation to over 40,000 cases countries such as South Korea and Thailand have become much more strict in their travel requirements in order to protect their citizens. While these travel bans are encouraged, notable scientists claim they likely won’t be enough now that the coronavirus has diffused to the point where it has, meaning more worldwide cases are expected in the future.
In addition to travel bans into and out of countries in the region, many cruise liners have been affected by the outbreak. Currently 3 cruises are sitting in ports in Japan and Thailand under quarantine keeping thousands of international travelers and crew aboard through testing and incubation period of the disease. One cruise has reported over 135 positive cases, 24 of whom are American, on board. Further cruises have been cancelled or rerouted in the midst of the crisis affecting global companies such as Princess, Holland, Carnival, and Norwegian cruise lines.
How to keep yourself safe:
Wash your hands and sanitize often. It is well known that alcohol can kill the coronavirus as can high temperatures. Therefore it is important to keep your hands clean if at all possible.
Stay home if you can. This virus can be transmitted person to person just through being in the air. If you are at all concerned or showing any symptoms keep everyone safe by quarantining yourself. Even if you are asymptomatic you may still spread the virus, so it is important to avoid contact as much as possible.
While the chances of exposure in the United States are low there have been cases in Arizona, Illinois and Chicago where person to person transfer has occurred.
Change travel plans. If you were planning a trip to China, or even another country in southeastern Asia perhaps it is time to reconsider those plans. While it’s never fun to cancel or postpone a trip, visiting the country where an epidemic is currently sweeping is never a good idea. (Before you cancel you can purchase travel insurance to cover the cost of your trip either in postponing or canceling entirely.)
What do I do if I’ve been exposed?
If you believe you have come into contact with someone who tested positive for the coronavirus anywhere in the world, stay home and call your nearest hospital. It is important to quarantine yourself and monitor your temperature closely. If symptoms do appear further contact your healthcare providers for specific instruction.
Officials have yet to determine if this outbreak will be similar to SARS in that it will be mostly eradicated after initial outbreak, or if it will persist in the way H1N1 has in taking on a seasonality of its own. Unfortunately it’s too early to report exact transmission patterns, death rate, or length of outbreak based on current numbers. Some experts are reporting that the expected peak is in mid march meaning the warmer temperatures of summer will cause a strong decline in cases through near eradication. However, other scientists have less hopeful outcomes stating the travel bans were not fast enough or strict enough to prevent what they call a “diffused outbreak” meaning we can expect many more cases throughout the world. Whichever the case may be, we do know the outbreak is not over yet and we must do all we can to keep ourselves and each other safe in these trying times.