What it will take to stop the Wuhan coronavirus

What it will take to stop the Wuhan coronavirus
By Laurie Garrett
Jan 24 2020
https://www.cnn.com/2020/01/24/opinions/wuhan-coronavirus-china-strategy-garrett/index.html

(CNN) — On this date 17 years ago, I was covering the severe acute respiratory syndrome (SARS) virus for several months as it spread across Asia, eventually reaching 37 countries, sickening 8,098 people and killing 774 of them.

So, as I read the first reports of a cluster of animal-market related illnesses, with the first patient exhibiting symptoms of pneumonia as early as December 12, 2019, I had a chilling sense of déjà vu. By New Year’s Eve, it was obvious something akin to SARS — as it turns out, the Wuhan coronavirus is in the same family of viruses as SARS and MERS (Middle East respiratory syndrome) — was unfolding in China.

The mysterious pneumonia virus that emerged from a live animal market in China’s central city of Wuhan last month has now infected far too many people, over far too vast a geographic area, to be easily controlled.

The Wuhan coronavirus — part of a family of viruses that are common among animals and can cause fever as well as respiratory symptoms when transmitted to humans — has been found in cities all over China, and travelers have since spread the virus to several countries, including Singapore, Japan, Vietnam, Taiwan and South Korea as well as Hong Kong and Macau.

The first American case — involving a man in his 30s who recently traveled to Wuhan — was confirmed outside Seattle on January 21, before the Centers for Disease Control and Prevention announced on Friday a second case in Chicago. As of Friday, at least 41 people have died from the illness.

I warned that China appeared to be taking more aggressive steps shutting down social media posts, arresting people accused of spreading “rumors” and capping the flow of information about the outbreak than it was halting the transmission of the virus. For more than a week, the reported number of cases barely changed after local authorities shut down the Huanan Wholesale Seafood Market, the putative source of the virus. And authorities insisted the cause was neither SARS, nor similar viruses like the flu, avian flu, or MERS.

They also repeatedly stated that there was no evidence of human-to-human spread of the disease (which turned out to be false), leading the World Health Organization and outside world to believe that closing the live animal market effectively brought the outbreak to a halt.

As recently as January 18, the Chinese Center for Disease Control and Prevention posted stern warnings against paying heed to “rumors” and insisted there were no cases of the disease in hospitals outside of Wuhan, adding that the outbreak was “preventable and controllable.”
But we now know that was far from true.

Officially, there are more than 1,000 cases of the Wuhan coronavirus. Unofficially, however, the toll is likely to be far higher, and more than 20 Chinese cities have reported cases of the coronavirus. 

Separate studies from London’s Imperial College and Hong Kong University Medical School estimated that some 1,300 to 1,700 people were infected during the first week of January, when Chinese officials reported just a handful of cases and downplayed the epidemic’s severity. This week, the Imperial College team estimated that there were a total of 4,000 cases (with the possibility of up to 9,700 cases in the worst-case scenario) by January 18, when the official tally was still at 62 cases.

Using a different statistical method, scientists at Northeastern University in Boston reckon that 5,900 were infected by January 23.

Despite the wide disparity in the figures, this new epidemic seems poised to eclipse the scale of the 2003 SARS epidemic, and is already well outside of the reach of simple control measures.
Hong Kong University virologist Guan Yi, who was part of the team that discovered the SARS virus, tells the Washington Post that the epidemic is so out of control now that “a bigger outbreak is certain.” He said that even with a conservative estimate, the outbreak could be 10 times bigger than the SARS epidemic — with a reach of more than 80,000 cases.
Speaking on background, other SARS veterans tell me there may already be “many thousands” of infected individuals in China.

Because authorities initially downplayed the seriousness of the outbreak instead of implementing swift control measures, people have traveled to and from Wuhan — a major transportation hub with a population of 11 million people — and unwittingly carried the virus with them.

Chinese authorities have shut down flights, ferries, highways, and trains leaving Wuhan, as well as public transportation within the city. Twelve other cities in China have issued travel restrictions in an unprecedented move to contain the virus just days before the Lunar New Year on January 25, which usually ushers the largest human migration on earth, with hundreds of millions of people traveling to see relatives.

Following my January 8 claim that the Chinese government was covering up a significant epidemic, pressure mounted from United Nations agencies, Ministries of Health worldwide and the scientific community. Finally, Wuhan provincial communist party chief Jiang Chaoliang, and his counterparts in neighboring districts, came under veiled criticism from President Xi Jinping who ordered Party leaders to “put people’s safety and health as the top priority and take effective measures to curb the spread of the virus.”

On January 20, China’s National Health Commission designated the new disease a Class B infection, although it was treating the virus as a Class A infection — meaning mandatory quarantines and community lockdowns may be used to stop its spread.

And the following day, the Central Political and Legal Affairs Commission posted on social media that, “Anyone who puts the face of politicians before the interests of the people will be the sinner of a millennium to the party and the people.” The commentary also warned that “anyone who deliberately delays and hides the reporting of cases out of his or her own self-interest will be nailed on the pillar of shame for eternity” and stressed that transparency was the best defense against rumors and widespread fear.

Not surprisingly, reported numbers of cases from all over China jumped dramatically after Xi’s speech and subsequent pressure from Beijing. This has confused matters considerably, making it impossible to tell how much of the soaring epidemic toll is due to a surge in actual new infections, versus release of case numbers that local authorities had been covering up.
Worse, despite calls for openness, SARS hero Dr. Zhong Nanshan, who was celebrated for his 2003 efforts, gave a televised interview on January 20 in which he warned that 14 healthcare workers were infected in Wuhan, the risk to medical personnel is acute, and severity of threat will rise if the virus mutates. Zhong, who had initially made several appearances on Chinese television, has not been featured on broadcasts in recent days, with some speculating that the government is now silencing him. 

But Zhong’s warning represented sound science. As the leading Chinese virology team wrote, after comparing the genetics and proteins of the new virus and SARS, “the Wuhan nCoV poses a significant public health risk for human transmission,” because it — like SARS — has the ability to bind to a protein found on the surface of most human lung cells. “People also need to be reminded that risk and dynamic of cross-species or human-to-human transmission of coronaviruses are also affected by many other factors,” like the host’s immune response, the speed with which the viruses can multiply inside human lungs, and the potential mutations that might make the virus more virulent or transmissible.

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