PART3. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)

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NEW PART 3. “The Wuhan coronavirus spreading from China is now likely to become a pandemic that circles the globe…”..Trump appeared to downplay concerns about the flu-like virus …We’re gonna see what happens, but we did shut it down..” (D)

The prospect is daunting. A pandemic — an ongoing epidemic on two or more continents — may well have global consequences, despite the extraordinary travel restrictions and quarantines now imposed by China and other countries, including the United States.

Scientists do not yet know how lethal the new coronavirus is, however, so there is uncertainty about how much damage a pandemic might cause. But there is growing consensus that the pathogen is readily transmitted between humans.

The Wuhan coronavirus is spreading more like influenza, which is highly transmissible, than like its slow-moving viral cousins, SARS and MERS, scientists have found.

“It’s very, very transmissible, and it almost certainly is going to be a pandemic,” said Dr. Anthony S. Fauci, director of the National Institute of Allergy and Infectious Disease.

“But will it be catastrophic? I don’t know.”

In the last three weeks, the number of lab-confirmed cases has soared from about 50 in China to more than 17,000 in at least 23 countries; there have been more than 360 deaths.

But various epidemiological models estimate that the real number of cases is 100,000 or even more. While that expansion is not as rapid as that of flu or measles, it is an enormous leap beyond what virologists saw when SARS and MERS emerged.” (A)

“The World Health Organization declared a global health emergency on Thursday as the coronavirus outbreak spread well beyond China, where it emerged last month.

The move reversed the organization’s decision just a week ago to hold off such a declaration. Since then, there have been thousands of new cases in China and clear evidence of human-to-human transmission in several other countries, including the United States.

All of which warranted a reconsideration by the W.H.O.’s emergency committee, officials said.

The declaration “is not a vote of no confidence in China,” said Tedros Adhanom Ghebreyesus, the W.H.O.’s director-general. “On the contrary, the W.H.O. continues to have confidence in China’s capacity to control the outbreak.”

The declaration comes now, he said, because of fears that the coronavirus may reach countries with weak health care systems, where it could run amok, potentially infecting millions of people and killing thousands.” (B)

“The Donald Trump administration declared the coronavirus outbreak to be a public health emergency in the United States on Friday, setting quarantines of Americans who have recently been to certain parts of China.

Centers for Disease Control and Prevention officials said it was the first quarantine order issued by the federal government in over 50 years. Marty Cetron, director of CDC’s Division of Global Migration and Quarantine, said the last time a quarantine was used was in the 1960s for smallpox…

U.S. citizens who have been in China’s Hubei province during the past 14 days and are returning to the U.S. States will undergo health screenings and be monitored during mandatory quarantines of up to 14 days, officials said.

Azar also announced a temporary suspension of entry into the United States of foreign nationals who pose a risk for the transmission of the coronavirus.

As a precaution, any U.S. citizen who has been anywhere else in mainland China beyond Hubei province will be screened when they return for evidence of coronavirus symptoms. They will also be subject to self-quarantines of up to 14 days and monitored by local health officials.

All flights from China to the U.S. will be funneled to one of seven airports that are designated ports of entry: New York, San Francisco, Seattle, Honolulu, Los Angeles, Chicago and Atlanta.” (C)

“The United States has taken decisive action to protect Americans from the threat of a fast-moving coronavirus while offering help to China, President Donald Trump said on Sunday, but a key adviser said Beijing had not accepted the offers of assistance.

Trump appeared to downplay concerns about the flu-like virus that has killed more than 300 people in China and spread to more than two dozen countries, telling Fox television in an interview, “We’re gonna see what happens, but we did shut it down, yes.” (D)

“People showing no symptoms appear to be able to spread the novel coronavirus that has caused an outbreak in China and led world health authorities to declare a global emergency, researchers reported Thursday in the New England Journal of Medicine. If confirmed, the finding will make it much harder to contain the virus.

The case described — from Germany — could help resolve one of the major unknowns about the virus, which as of Thursday night had infected nearly 9,700 people in China and killed 213. About 100 more infections have been reported in 18 other countries, but no deaths.

Some viruses, including SARS, which is another coronavirus, can only be passed when a person is showing symptoms. Others, like the flu, can be spread a day or two before the onset of symptoms. If people are contagious before they become sick, they can be unknowingly spreading the virus as they go shopping or to work or to the movies. Trying to snuff out the virus in that case is a much more difficult task.

What’s also concerning is that the spread from an asymptomatic person appeared to lead to two generations of cases, meaning the person who contracted the virus then passed it on to others.” (E)

“Close to 10,000 people have contracted the new coronavirus that originated in Wuhan, China—more cases than SARS in 2003. So far, 213 people have died. The preliminary fatality rate for 2019-nCoV hovers around 3%—which is low, but still concerning because of the number of cases accumulating.

But that fatality rate is likely to be higher in older adults. Unofficial open-source data from researchers based in the UK and China show that out of 41 deaths, 39 were in people over 50. Bloomberg reports similar figures. While that’s not unexpected, it indicates the need for effective therapies targeted at this population. And as the proportion of adults over 50 continues to increase globally, future pandemics could be deadlier than they’ve been in the past…

There are two reasons older adults are more susceptible to infections. First, seniors are more likely to have other chronic health conditions, like diabetes or chronic obstructive pulmonary disease, that make it harder for their bodies to cope with damage caused by a new pathogen. Every year, the majority of flu deaths are seen in people 65 or older.

Second, the immune system changes with age—particularly in its ability to respond to coronaviruses. Unlike the flu virus, which does most of the damage to your body on its own, most of the symptoms from coronavirus infections actually come from the body’s immune response, Menachery says. Although he and his lab team are still characterizing these reactions, it seems like coronaviruses encourage older immune systems to kick in with extra inflammation, which can have a cascading effect.” (F)

“Two more Americans, a husband and wife, were confirmed to have the coronavirus late Sunday in the second person-to-person transmission in the U.S. and the 10th and 11th cases in the country, respectively.

The husband, from San Benito County, California, recently traveled to Wuhan, China, the center of the virus’ outbreak, and apparently passed the disease to his wife, who did not go to China. Both 57, neither has been hospitalized, but they have also not left their home.

The couple’s diagnosis brings the total number of positive cases in the United States to 11. The ninth case in the country, in Santa Clara County, California, was announced Sunday afternoon. The other human-to-human transmission was also between a husband and wife and was announced last week in Illinois.” (G)

“Stopping the spread of a rapidly emerging disease takes masterful medical detective work, including tracing the people who have been infected and figuring out their web of contacts, steps that are vital to understanding how it’s being transmitted. US public health officials are following those trails to quickly detect new cases of the Wuhan coronavirus, including the report on Thursday of a sixth US infection—the husband of a woman who became ill after traveling from China back home to Chicago—which was followed by a seventh, in California, on Friday.

Yet there’s a potential wildcard, a deviation that throws off the most careful calculations. For reasons that are still unclear, some people, known as super-spreaders, transmit disease much more readily than others, and to many more people. Like an infectious grenade, they can set off a sudden cluster of illnesses. “These super-spreader events are very unique and fall out of the world of averages,” says Michael Osterholm, an infectious disease expert and director of the Center for Infectious Disease Research and Policy at the University of Minnesota. Yet super-spreading can shape the trajectory of an outbreak in unexpected ways, making it more difficult to control. Instead of infecting just a few people who are close to them, a super-spreader may inadvertently infect dozens—who go on to spread the disease elsewhere.” (H)

“Can wearing a medical face mask protect you against the new coronavirus? It’s a question many people, including pet owners who are putting canine face masks on their dogs, are asking.

If it’s a regular surgical face mask, the answer is “no,” Dr. William Schaffner, an infectious-disease specialist at Vanderbilt University in Tennessee, told Live Science.

A more specialized mask, known as an N95 respirator, can protect against the new coronavirus, also called 2019-nCoV. The respirator is thicker than a surgical mask, but Schaffner doesn’t recommend it for public use, at least not at this point.” (I)

“New York City health officials announced on Saturday that a patient at Bellevue Hospital Center might have the new coronavirus and that samples were being sent to the federal authorities for laboratory testing. If confirmed, it would be the first known instance of the virus in New York City.

Based on the patient’s symptoms and travel history from China, city officials were taking the potential case seriously. This was the first time city officials had sent a sample to the Centers for Disease Control and Prevention for testing.

Another reason the health authorities suspect it might be the new coronavirus: They had tested the patient for influenza and other common illnesses, and those tests came back negative, health officials said.

They said they did not expect to receive results from the C.D.C. for 36 to 48 hours, or possibly longer.

“An individual with a travel history to China felt unwell and sought help from a medical provider who promptly contacted the Health Department,” the health commissioner, Dr. Oxiris Barbot, said in a statement.” (J)

“China completed building on Sunday a massive, makeshift hospital in Wuhan that will serve as the frontline in battling the coronavirus epidemic, according to a report.

Huoshenshan Hospital was built in less than two weeks to treat patients at the epicenter of the virus that has killed more than 300 people, BBC reported.

The hospital, which has 1,000 beds, started construction Jan. 23 and will begin admitting patients on Monday, according to Chinese state media China Global Television Network.

Around 40 million people tuned into livestreams of the construction on YouTube and Periscope, while workers rushed to complete one of two hospitals that will specialize in treating the virus.

Chinese officials are still working to build the second emergency hospital, Leishenshan Hospital, which is expected to open Wednesday around 25 miles away from the newest site, CGTN reported.” (K)

“The 195 Americans who flew from China to California were first told they must clear medical tests that could take 72 hours or many days. Now they are all being quarantined for two weeks…

This makeshift community on a military base in Riverside, Calif., is made up of evacuees from Wuhan, the city in China that is the epicenter of the coronavirus outbreak. The 195 people, including diplomats, infants, a football player and a theme-park designer, are among Americans who have managed to leave Wuhan since a quarantine was imposed.

Now they find themselves stuck in place in the United States. The federal government on Friday imposed a 14-day quarantine, retroactive to when the plane left Wuhan. The patients were initially told they had to wait at least 72 hours for medical testing to be completed.” (L)

“The BlueDot algorithm scours news reports and airline ticketing data to predict the spread of diseases like those linked to the flu outbreak in China.

On January 9, the World Health Organization notified the public of a flu-like outbreak in China: a cluster of pneumonia cases had been reported in Wuhan, possibly from vendors’ exposure to live animals at the Huanan Seafood Market. The US Centers for Disease Control and Prevention had gotten the word out a few days earlier, on January 6. But a Canadian health monitoring platform had beaten them both to the punch, sending word of the outbreak to its customers on December 31.

BlueDot uses an AI-driven algorithm that scours foreign-language news reports, animal and plant disease networks, and official proclamations to give its clients advance warning to avoid danger zones like Wuhan.

Speed matters during an outbreak, and tight-lipped Chinese officials do not have a good track record of sharing information about diseases, air pollution, or natural disasters. But public health officials at WHO and the CDC have to rely on these very same health officials for their own disease monitoring. So maybe an AI can get there faster. “We know that governments may not be relied upon to provide information in a timely fashion,” says Kamran Khan, BlueDot’s founder and CEO. “We can pick up news of possible outbreaks, little murmurs or forums or blogs of indications of some kind of unusual events going on.” (M)

““The outbreak is probably a lot bigger than one the public health officials have confirmation of,” says James Lawler, an infectious disease specialist at the University of Nebraska Medical Center, who treated quarantined Ebola patients in 2017 and 2018. “Just using a back-of-the-envelope calculation on how many travelers there are from China in a given week, and percentage than might have been affected, it’s a lot.”

An area containing eight cities and 35 million people have now been quarantined in China, The New York Times reported Friday, while The Wall Street Journal reports that hospitals in the epicenter of Wuhan are turning away patients and medical supplies such as masks and sanitizers have run out.

Lawler and others say that the coronavirus outbreak will continue to spread as travelers from China to other nations exhibit symptoms of infection. He says we still don’t know how many people will get sick, and how many of those will die before the outbreak recedes.

To stop the spread of disease, public health officials will need to tell the truth and tell it quickly. But in the meantime, it might be worth deputizing an AI-driven epidemiologist.” (N)

As the coronavirus outbreak continues to spread across China, a flurry of early research is drawing a clearer picture of how the pathogen behaves and the key factors that will determine whether it can be contained.

How contagious is the virus?

It seems moderately infectious, similar to SARS.

How deadly is the virus?

It’s hard to know yet. But the fatality rate is probably less than 3 percent, much less than SARS.

How long does it take to show symptoms?

Possibly between 2 to 14 days, allowing the illness to go undetected.

How much have infected people traveled?

The virus spread quickly because it started in a transportation hub.

How effective will the response be?” (O)

“The World Health Organization has declared the growing coronavirus outbreak in China to be a global health emergency. It’s a recognition that the outbreak — now with nearly 10,000 cases — may continue to spread beyond China, and that the nations of the world should lend their assistance and be prepared.

Just a month ago, this virus, called 2019-nCoV, was unknown to science. Now, health officials are working furiously to understand it, trying to prevent a pandemic (a larger global spread of an infection).

These are still early days. Critical questions about the virus — namely how it spreads, and how deadly it is — remain to be firmly answered. But it’s not too soon to wonder: How does this outbreak end?

Right now, infectious disease experts are outlining three broad scenarios for the future of this outbreak. Keep in mind there’s a lot of uncertainty about how this will unfold.

1) The spread of the virus gets under control through public health interventions

This is the best-case scenario, and essentially what happened with the SARS (severe acute respiratory syndrome) outbreak in 2003…

2) The virus burns itself out after it infects all or most of the people most susceptible to it

Disease outbreaks are a bit like fires. The virus is the flame. Susceptible people are the fuel. Eventually, a fire burns itself out if it runs out of kindling. A virus outbreak will end when it stops finding susceptible people to infect.

3) Coronavirus becomes yet another common virus

There’s a third scenario about how this outbreak ends. That it doesn’t.

This has happened before. In 2009, a new strain of the H1N1 flu virus encircled the globe in a pandemic. But, “after a while it became a part of our normal repertoire of what might come up each flu season,” Mina says.” (P)

“Each new crisis follows a familiar playbook, as scientists, epidemiologists, health-care workers, and politicians race to characterize and contain the new threat. Each epidemic is also different, and each is a mirror that reflects the society it affects. In the new coronavirus, we see a world that is more connected than ever by international travel, but that has also succumbed to growing isolationism and xenophobia. We see a time when scientific research and the demand for news, the spread of misinformation and the spread of a virus, all happen at a relentless, blistering pace. The new crisis is very much the kind of epidemic we should expect, given the state of the world in 2020. “It’s almost as if the content is the same but the amplitude is different,” Bhadelia said. “There’s just a greater frenzy, and is that a function of the disease, or a function of the changed world? It’s unclear.”

And there will be a next epidemic. A new disease was always going to rear its head to test the world’s mettle, and more almost certainly will in the future. As I argued in 2018, the world isn’t ready. There has assuredly been progress—vaccines can be produced faster, global cooperation is tighter, basic research is nimbler—but supply chains are stretched, misinformation is rife, and investments in preparedness always fall into neglect once panic subsides. “Every year, things get more and more connected,” Inglesby says. “Epidemics like this show that all of it can be relatively quickly put at risk.” (Q)

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