By Melanie Sison
The Chinese city of Wuhan, identified as the epicentre of a coronavirus outbreak that has left 25 confirmed dead, has been put on lockdown along with seven neighbouring cities as authorities battle to contain the virus.
The novel coronavirus (2019-nCoV), which emerged in December, is believed to have originated from a seafood market in Wuhan. It causes flu-like symptoms and, in more severe cases, can lead to pneumonia, severe acute respiratory syndrome, kidney failure, and death.
By Friday morning (24 January), the number of cases in China had risen to 830 from 634 only a day before, according to China’s National Health Commission.
Cases have also been confirmed in Japan, Saudi Arabia, Singapore, South Korea, Taiwan, Vietnam and the US, while there have been unconfirmed cases in the Philippines and Mexico, raising fears of a global epidemic. The World Health Organization (WHO), however, stopped short of declaring it an international emergency this week.
Chinese authorities have confirmed that the virus can spread by human-to-human transmission and warned that it could mutate into deadlier forms.
Wuhan, the capital of Hubei province and home to more than 11 million people, has been quarantined, with travel in and out of the city suspended, and entertainment venues like cinemas and cafes shut. Similar measures were imposed Thursday on the cities of Huanggang and Ezhou with a combined population of 9 million. Travel restrictions were also placed on smaller cities of Chibi, Lichuan, Quianjiang, Xiantao and Zhijiang on Friday.
Several countries, including Australia, Bangladesh, Canada, India, Malaysia, Singapore, South Korea and the US have begun screening travellers, particularly those coming in from China, for signs of fever, cough and flu-like symptoms.
“Given travel patterns and increased testing, more cases of 2019-nCoV should be expected in other parts of China and possibly other countries in coming days,” a WHO spokesperson said in a statement to SciDev.Net.
While there has been criticism over the severity of the measures taken by the Chinese government, Edsel Salvaña, director, Institute of Molecular Biology and Biotechnology, National Institutes of Health, University of the Philippines Manila, believes that the action is warranted. “I think it is always best to be on the safe side when dealing with an unknown virus.
“There is always a danger [of an outbreak] especially if it is a respiratory virus and there is no immunity to it because it is a new pathogen,” said Salvaña.
Allegations that the government of China — which tightly regulates the press — is covering up the actual number of cases appeared prompted by the 2002—2003 Severe Acute Respiratory Syndrome (SARS) outbreak that killed nearly 800 people globally and which Beijing was slow in admitting.
A study released earlier this month by scientists at the MRC Centre for Global Infectious Disease Analysis, Imperial College London, concluded that there were “substantially more cases of moderate or severe respiratory illness than currently reported”. They estimated that there could be as many as 4,000 people sick with the novel coronavirus.
While China has shared the genetic sequencing of 2019-nCoV, much remains unknown about the virus. “We are still in the very early stages of understanding this disease and there is still a lot we don’t know,” the WHO statement said. “We will continue to monitor information on both current and new cases, as this is critical to enhancing our understanding of the severity of the illness.
Tom Frieden, former head of the Centers for Disease Control and Prevention in the US and currently chief of Resolve to Save Lives, said: “There are still many unknowns with the newly discovered coronavirus. It can cause something as benign as the common cold as also something as deadly as SARS. What we don’t know is where the novel coronavirus fits on that spectrum.”
“While we wait to learn more, follow cold and flu prevention measures: wash your hands often, cover your mouth (when coughing), and avoid travel and crowds if you’re sick,” Frieden advised.
Pre-existing health conditions may make individuals more susceptible to a severe form of the novel coronavirus, added the WHO spokesperson. “People with existing chronic conditions appear to have increased vulnerability to more severe illness.”
Hypertension, cardiovascular problems, respiratory and liver issues and diabetes can exacerbate the effects of the coronavirus. The elderly may also be more susceptible to a more severe form of the disease.
On 23 January, following a meeting with the Emergency Committee convened by WHO Director-General Tedros Adhanom Ghebreyesus, the WHO determined that it was too earlyto declare of a global health emergency, given the current circumstances. “Make no mistake. This is an emergency in China, but it has not yet become a global health emergency,” said Ghebreyesus.
However, the committee agreed on the urgency of the issue and committed to continually monitor the virus. The body also provided recommendations to all countries, including taking measures such as active surveillance, early detection, and containment.
“The decision about whether or not to declare a public health emergency of international concern is one I take extremely seriously, and one I am only prepared to make with appropriate consideration of all the evidence,” said Ghebreyesus in a previous statement.
Jeremy Farrar, director of the London-based health research foundation Wellcome, warned that more cases may surface with the onset of the Chinese Lunar New Year celebrations, which run from January 25 for about two weeks. “We know there is more to come from this outbreak, and with travel being a huge part of the fast approaching Chinese New Year, it is right that concern levels are at the highest level.”
A state-run news outlet, however, announced that the Chinese government is set to cancel the planned Chinese Lunar New Year celebrations to prevent the spread of the coronavirus.
This piece was produced by SciDev.Net’s Asia & Pacific desk.