The Wuhan coronavirus (aka 2019-nCoV) is spreading rapidly. The Chinese authorities are taking drastic measures to try to stop the spread of the contagion. Health experts around the world are working at an unprecedented speed and scale to identify the virus and its properties, to develop vaccines, to predict the spread of the disease and to guide the response to the epidemic by health officials.
Here is a quick synopsis of the status of the Wuhan coronavirus —
Date (EST) |
WorldWide Cases |
China Cases |
Deaths |
Jan 31 evening |
15,153 |
14,380 |
304 |
Jan 30 evening |
9,822 |
9,692 |
213 |
Jan 29 evening |
7,814 |
7,711 |
170 |
Jan 28 evening |
6,058 |
5,974 |
132 |
Jan 25 morning |
1,354 |
1,320 |
41 |
- About 20% of cases are reported as severely ill.
- Besides the high number of cases in China, small number of cases have been detected in the U.S. (5), Canada, France, Thailand, Malaysia, Singapore, Hong Kong, Taiwan, Macau, Japan, South Korea, Vietnam, Cambodia, Australia, Germany, Sri Lanka and Nepal.
- The virus is known to be transmitted human-to-human (H2H). An analysis of 24 genetic sequences suggests that the outbreak probably began with a single introduction of a virus from animal to human, presumably in the Wuhan market in November or early December.
- The virus incubation period is about 1 to 2 weeks.
- The 2019-nCoV causes symptoms similar to SARS-CoV and MERS-CoV. The flu-like symptoms are milder than SARS or MERS, but 2019-nCoV is known to cause pneumonia and serious illness. The elderly and those with other health problems are more susceptible to complications. Deaths so far are associated with older men with prior health problems. The death of a 36-year old male is an outlier.
- Diagnostic tests have been developed by WHO and are conducted in the U.S. by the CDC.
- WHO has not yet classified this outbreak as a global health emergency.
- There is no approved vaccine or antiviral treatment available for coronavirus infection yet (including SARS and MERS).
- Projections of the spread of the virus look dire.
The Response so far
- Wuhan and many other cities in China are in lockdown state, with no travel allowed in and out of the cities. Travel within Wuhan has also been restricted.
- The U.S. State Department says to reconsider travel to China, raises its advisory for the country to level 3 amid uncertainty over the spread of coronavirus.
- 2 new hospitals are currently being built in Wuhan at record speed — a 1,000-bed facility, to be completed within 6 days- and another 1,300-bed facility, to be completed within 14 days.
- Scientists across the world are analyzing the virus, understanding its properties and racing to develop vaccines in the next 2 to 3 months, although clinical testing will take longer.
- Researchers, including data scientists, are estimating and projecting the likely spread rate of the virus and providing guidance to health officials about the amount of containment necessary to stop the virus.
Tracking the virus
John Hopkins has an online dashboard that tracks the statistics of the spread of the virus. Check it out. bnonews.com/… also has an up-to-date count.
The Projected Spread Rate of the Virus
The rate at which a virus spreads can be mathematically computed and projected based on certain key parameters. One of the parameters that you may have heard of recently is called R0. R0, the basic reproduction number, is the average number of secondary infections caused by a typical infective person in a totally susceptible population (i.e., without isolation or other means to control the spread). For example, an R0 number of 2.6 means that on average, an infected person will pass the virus on to 2.6 other people. A value above 1.0 means that the disease will spread across the population, unless measures are taken to effectively reduce R0 below 1.0.
The individual reproductive number represents the number of secondary infections caused by a specific individual during the time that individual is infectious. Some individuals have significantly higher than average individual reproductive numbers and are known as super-spreaders.
The other parameter, the dispersion parameter k can be interpreted as a measure of the probability of superspreading events (the lower the value of k, the higher the probability of superspreading).
R0 has been estimated to lie between 1.4 and 3.0, with some researchers estimating higher values. At R0 = 2.6, control measures need to block well over 60% of transmissions to be effective in controlling the outbreak.
The JonRead R0 value has been updated to 2.5, more in line with other estimates.
The curve fit to existing data is exponential in nature :(
Here are some R0 numbers to provide context -
Read’s group estimates that only about 5.1 percent of cases in Wuhan have been identified. That’s probably not because the Chinese government is covering up the data, it is simply that many people have not shown up at clinics yet due to the mild initial symptoms.
Read’s paper issues some dire projections and warnings -
- If no change in control or transmission happens, then we expect further outbreaks to occur in other Chinese cities, and that infections will continue to be exported to international destinations at an increasing rate.
- In 14 days’ time (4 February 2020), our model predicts the number of infected people in Wuhan to be greater than 190,000 (prediction interval, 132,751 to 273,649). We predict the cities with the largest outbreaks elsewhere in China to be Shanghai, Beijing, Guangzhou,Chongqing and Chengdu. We also predict that by 4 Feb 2020, the countries or special administrative regions at greatest risk of importing infections through air travel are Thailand, Japan, Taiwan, Hong Kong, and South Korea.
- Our model suggests that travel restrictions from and to Wuhan city are unlikely to be effective in halting transmission across China; with a 99% effective reduction in travel, the size of the epidemic outside of Wuhan may only be reduced by 24.9% on 4 February.
Other Activities in the race to stop the virus
The race to develop vaccines is on -
NIH and the researchers it funds plan on a vaccine within 3 months -
They can try experimental treatments right there in Wuhan -
Science at the speed of light …
This is all preliminary, but provides hope that some drugs might be effective in slowing down the spread -
City Lockdowns
The city lockdowns have been met with some criticism. It caught the World Health Organization by surprise, who do not recommend such an action. Lawrence Gostin, director of the O'Neill Institute for National and Global Health Law at Georgetown University Law Center says — "The most important thing in public health is not to drive the population underground and make them fearful, You want them to cooperate. You want them to report their symptoms. You need to go into communities where people have been infected. Isolate all cases. Then do contact tracing so that we know every single person that has been exposed."
Perhaps, we need both — lockdowns and contact tracing, with a supportive government.
Some more info on Coronavirus
- Coronaviruses were discovered in the 1960s.
- Coronaviruses represent 10 to 30 percent of common colds.
- SARS and MERS viruses are also coronaviruses.
- Both SARS-CoV and MERS-CoV originated from bats, in China and the Middle East respectively.
- In the case of SARS, the virus jumped from bats to civets before gaining the ability to infect humans. In the case of MERS, camels served as the intermediate host.
- The Wuhan coronavirus is between around 87% genetically similar to the SARS-CoV. www.nejm.org/...
- The virus incubation period is about 1 to 2 weeks. There are few symptoms during this period.
- Unlike SARS, 2019-nCoV is infectious during its incubation period (aka asymptomatic transmission) according to Chinese authorities. CDC has not confirmed this yet.
- Dried coronavirus e.g., SARS-CoV can be viable on surfaces for many days under air-conditioning type environmental conditions. One would expect similar properties for 2019-nCoV.
- The Wuhan coronavirus was initially identified during mid-December 2019, as an emerging cluster of people with pneumonia with no clear cause, which was linked primarily to stallholders who worked at the Huanan Seafood Market. en.wikipedia.org/...
- The Wuhan (fish) market, where the virus originated, was shut down on Jan.1 to limit the spread of 2019-nCoV, but more cases have since been identified, meaning the virus can also be spread from person-to-person.
- It looks like patient #1 reported by Wuhan authorities had no contact with the fish market. Which implies that the infection did not originate at the fish market, but was present earlier, possibly in November, and was transmitted H2H. www.trackingzebra.com/...
- There is no approved vaccine or antiviral treatment available for coronavirus infection yet. Several organizations as noted above are racing to develop one.
- SARS and MERS were contained through symptomatic treatment, isolation and quarantine.
This is a timeline of the onset of coronavirus infection based on initial cases in Wuhan.
This figure shows a timeline of the spread of coronavirus around the world.
An actual image of 2019-nCoV -
A model of the crystal structure of 2019-nCoV main proteinase (an enzyme)-
Snakes?
A preliminary DNA/RNA analysis had identified snakes — the Chinese krait and the Chinese cobra — as the possible intermediary host of the virus, with origin in bats. Other scientists doubted that the virus could jump and proliferate from warm-blooded bats to cold-blooded reptiles to warm-blooded humans. Additional analysis of the virus DNA data shows that reptilian DNA is not required to explain the genetic makeup of the virus. This shows the power of open collaboration and sharing of data, all at breakneck speed.
Medical information
For medical information, check out the CDC site —
Some Grim Assessments
Guan Yi, the virologist who identified SARS, offered a chilling (perhaps hyperbolic?) perspective on the situation at www.nationthailand.com/...
A bigger outbreak is certain. Conservatively, this outbreak could be 10 times bigger than the SARS epidemic because that virus was transmitted by only a few “super spreaders” in a more defined part of the country.
I’ve seen it all: bird flu, SARS, influenza A, swine fever and the rest. But the Wuhan pneumonia makes me feel extremely powerless. Most of the past epidemics were controllable, but this time, I’m petrified.
Dr. Neil Ferguson on what needs to be done besides containment -
Epilogue
2020 has so far been off to a very rough start — when it comes to weather and natural disasters. We had Australian bushfires, floods in Indonesia, deadly earthquakes in Puerto Rico, heavy rains in east Africa, Angola and Israel, the Taal volcano eruption in the Philippines and locust swarms in East Africa. All this is on top of the man-made disasters created by the WH and the downing of the Ukrainian airliner.
In this day and age of global travel, the dispersion factor (k) is much higher than in older times and the chance of this spreading across the globe is high. Not every country has the resources to stop its spread once the virus lands on its shores. Let’s hope the Chinese and UN authorities, and scientists and health workers manage to get control over this Wuhan coronavirus before it becomes a global disaster.
A Note
Note that the purpose of this diary is to inform, not to make predictions or to prescribe individual actions. In the coming days, there will be a flurry of articles in the MSM, some accurate, others not, some alarming and others designed to attract eyeballs.
In general, it is best not to give too much credence to individual stories and quotes and best to look at the sum total of all the info. coming out of reliable sources like the CDC and the scientific community. Also, we should take simple precautions, as we normally do, to avoid catching the cold and the flu.
Also, keep in the mind that health sciences are much more advanced today than they were in 1918, even much more than they were in 2003.
Further Reading
- How the new coronavirus stacks up against SARS and MERS — www.sciencenews.org/…
- Clinical features of patients infected with 2019 novelcoronavirus in Wuhan, China — www.thelancet.com/…
- PATTERN OF EARLY HUMAN-TO-HUMAN TRANSMISSION OFWUHAN 2019-NCOV — www.biorxiv.org/…
- Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic predictions — www.medrxiv.org/…
- Novel coronavirus (2019-nCoV) — en.wikipedia.org/...
- Coronavirus: Its original source is possibly ... Snakes — www.dailykos.com/…
Updates
What’s in a name?