As nations scramble to contain Wuhan coronavirus outbreak, CDC expands screening to 20 US airports
CDC official says “risk remains low at this time” for virus spreading in this country. Currently, the worst outbreaks are in China.
I had an opportunity to have lunch with the biosafety specialist and colleague this week, to do a preliminary risk assessment related to the Wuhan Coronavirus and its potential for the outbreak in China to blossom into a full-blown pandemic.
One of the biggest challenges in this exercise is the reliability of any of the data coming from China. Presently, we will assume that the death toll stands now at 169, with 7169 cases officially reported (including the five in the US).
Another data point that is lacking is precisely how easy is it to catch from another person? What is the viral load that a cough could create? How long does the virus live outside the body? These facts can be difficult to discern during the initial stages of an outbreak of a new pathogen.
Part of the process of obtaining reliable data is to screen passengers coming into this country, isolating potential cases during the evaluation process, and ascertaining whether an infection has occurred and what the health consequences are if someone has contracted the Wuhan Virus.
Therefore, the Centers for Disease Control and Prevention is now screening passengers arriving at 20 airports, which is an expansion from the original five where the procedures were first implemented.
U.S. Health Secretary Alex Azar warned Tuesday that the coronavirus raging across mainland China is a “potentially very serious public health threat,” saying that the Trump administration is expanding screening for the virus from five to 20 U.S. airports.
“We are constantly preparing for the possibility that the situation could worsen,” Azar said during a press briefing on the nation’s response to the coronavirus…
“Americans should not worry about their own safety,” Azar said. “Part of the risk we face is we don’t know everything we need to know about this virus … That does not prevent us from preparing and responding.”
Some facts that are currently known about coronavirus are: The rate of mortality is presently about 2.3%, which is on par with influenza mortality rates (especially when statistics on the elderly are considered. The cause of death associated with the virus is mainly kidney failure and bacterial pneumonia, and primarily among older adults and those with pre-existing medical conditions.
Based on the fact that the coronavirus still has not spread beyond the five patients in the US that have already identified, and the data that is currently available, the CDC deems the current risk of it spreading in this country as low:
As of Monday, there have been no confirmed reports of human-to-human transmission in the United States. Chinese officials caused a bit of a firestorm over the weekend when they suggested that human-to-human transmission may be possible during the 2- to 14-day “incubation” period, when those sickened are still asymptomatic.
However, Nancy Messonnier, director of the agency’s National Center for Immunization and Respiratory Diseases, said the CDC has “no clear evidence” of that at this point.
“At this time in the U.S., the virus is not spreading throughout the community,” she said. “The risk remains low at this time.”
The situation may be different in the other 16 countries to which the Wuhan Coronavirus has spread. The World Health Organization (WHO) will be reconvening this week to reassess the global health emergency status.
The coronavirus has spread to a handful of people through human-to-human contact outside of China, Dr. Mike Ryan, executive director of the WHO’s health emergencies program, said at a news conference at the organization’s Geneva headquarters Wednesday.
“These developments in terms of the evolution of the outbreak and further development of transmission, these are of grave concern and has spurred countries into action,” Ryan said, adding that he just returned from China on Wednesday. “What we know at this stage, this is still obviously a very active outbreak and information is being updated and changing by the hour.”
In this country, 195 Americans evacuated from Wuhan arrived in California, were greeted by medical professionals in hazmat suits, and are under voluntary quarantine.
American-based international firms (e.g., Amazon, Google) are telling those workers in China to work from home, and closing offices. There are currently 16 European and US airlines that have suspended flights to China.
In summary, the worst of these outbreaks seems to be contained in China. So, here’s the most practical advice I would give at this point:
- If you have been in China, especially in Wuhan or the other quarantined cities, and develop signs and symptoms of a cold or flu, then wash your hands frequently, cover your mouth, and go to the doctor after calling the office and expressing your concern. That will allow the medical staff to decide on appropriate infection control protocol.
- If you haven’t been to China or in direct contact with someone with an identified infection, and develop symptoms of a cold or flu…then wash your hands, cover your mouth, and make the decision about the kind of medical care you need without undue panic or anxiety.
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Comments
I read somewhere that the human virus was first detected in mid to late November. If that’s true, then the human to human transmission rate is probably no higher than the common flu.
The problem with the Kung Flu is that a carrier can transmit the virus up to 2 weeks before showing any signs.
Remember, this can still mutate. China was very unlucky, and lax in responding, in that 5 million people left ground zero, spreading far and wide. I doubt that they will be able to contain this.
https://gisanddata.maps.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
Interactive map of infection.
The apparent Wuhan virus mortality rate of 2.3% is not remotely “on par with” that of influenza; it’s orders of magnitude higher than that of flu. The paper you cited for the 2% mortality rate of influenza does not say that influenza has a 2% mortality rate; it says that influenza-caused deaths account for about 2% of all respiratory deaths.
It is important to make sure you’re comparing the same kind of “mortality rate” here. Influenza infections may cause a number of deaths this year comparable to the number caused by Wuhan – assuming that there are a thousand influenza infections for every Wuhan infection. But if you’re infected with Wuhan virus, you are far more likely to die than if you are infected with influenza.
1) There is evidence that the coronavirus ‘can also be spread via fomites – when the virus survives on inanimate surfaces for a short period of time,’ said Dr Maria Van Kerkhove, a member of the WHO’s emergency committee on the outbreak.
2) Seasonal flu has a US death rate of about 0.1, early determinations of Wuhan virus give a death rate as high as 3.0 or thirty times the death rate of seasonal flu.
3) Both the death rate and spread rate (Ro) are difficult to determine because of the opacity, prevarication, and CYA nature of the Chinese system. But it seems the Ro is also close to 3. Or one person spreads their illness to three people on average. The Ro for seasonal flu is 1.3 and for SARS it is 2.0.
4) Thailand’s health ministry has confirmed 14 cases of coronavirus, the second-most of any country behind China. China has more than 4,500 confirmed cases of the virus, mostly in the city of Wuhan, where the virus began. More than 100 Chinese people have died from the disease. Thailand health minister Anutin Charnvirakul said on Tuesday that the government is “not able to stop the spread” of coronavirus in the country, according to Sky News.
5) Several epidemiologists have suggested that many of the deaths caused by the coronavirus that surfaced in Wuhan last month have probably ‘slipped through the cracks’ – either having been misdiagnosed or deliberately attributed to something else. Many suspect that Beijing is concealing the true extent of the outbreak. And now, one reporter claims that a Chinese media organization has found proof. The East Asia Correspondent for DW cited reports in a tweet claiming that health officials have been secretly moving some bodies directly from the hospital to the crematorium:
“Also, one thing that #China is hiding is the number of death caused by the virus. Credible Chinese media outlet @initiumnews interviewed people working at local cremation centers, confirming that many dead bodies were sent directly from the hospitals to the cremation centers..”.— William Yang (@WilliamYang120) January 29, 2020
“… without properly identifying these patients, which means there are patients who died from the virus but not adding to the official record. That shows the current death toll of 133 that we are seeing is way too low.”— William Yang (@WilliamYang120) January 29, 2020
“So there are reasons to remain skeptical about what #Chins has been sharing with the world because while they have been more transparent about certain things related to the virus, they continue to be sketchy and unreliable in other aspects.”— William Yang (@WilliamYang120) January 29, 2020
6) Lancet published a study of a cluster of confirmed cases of 2019-nCoV in Wuhan Jinyintan Hospital from Jan 1 to Jan 20, 2020. The death rate was above 10% and deaths were associated with comorbidities or previous health conditions. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30211-7/fulltext
7) The emergency room model of health care is exacerbating the spread of the disease since people with colds and flu go to emergency rooms and mingle with infectious coronavirus patients.
8) Japan’s health minister Katsunobu Kato has announced that a bus driver in Nara Prefecture who drove for tourists from Wuhan twice in January has been confirmed infected with the new coronavirus in Japan.
9) Cases have so far been confirmed in Thailand, South Korea, Japan, Vietnam, the U.S., Canada, Singapore, Malaysia, Nepal, Australia, Hong Kong, Macao, Taiwan, India, Philippines, and France.
10) Here are the countries with domestic transmission (escaped) Wuhan virus infections: China, Japan,Thailand, France, Italy, South Korea and Germany
11) An Italian cruise ship with some 6,000 on board is being held at Civitavecchia, roughly 35 miles north of Rome, after a Chinese couple on board came down with the virus, according to the Daily Mail. The couple arrived in Italy on Jan. 25 and borded the ship in the port town of Savona. None of the passengers and crew are being allowed off the ship until everybody has been examined for signs of the virus.
12) The Wuhan coronavirus is more difficult to contain than other pandemics because those infected may not get a fever, a symptom governments around the world are using to screen for the pathogen. The National Health Commission told local governments and hospitals on Jan. 18 that some of those with the virus may not have a fever and the pathogen’s incubation period could be up to two weeks. The lack of fever as a symptom means that temperature screening — the main method now being deployed at airports and transport hubs to control the outbreak — would fail to pick up on at least some cases.
FYI
President Trump Establishes Coronavirus Response Task Force – Headed by HHS Secretary Alex Azar…
https://theconservativetreehouse.com/2020/01/30/president-trump-establishes-coronavirus-response-task-force-headed-by-hhs-secretary-alex-azar/#more-182239