By Larry Kummer, Editor / 25 January 2020
Summary: The hysterics have already begun to spread misinformation about the latest epidemic. The actual story is that so far we know little about it. The amazing news is the rapid and powerful response of our public health systems. This is evidence that we have built a better world, but it gets less attention than the number of characters allowed in a tweet. I will be posting updates in the comments.
You can read a dozen articles in the major news media and learn less than from reading the CDIC’s summary page about the latest epidemic. For busy people, here is an excerpt with the high points.
About the disease.
“CDC is closely monitoring an outbreak of respiratory illness caused by a novel (new) coronavirus (termed “2019-nCoV”) that was first detected in Wuhan City, Hubei Province, China and which continues to expand. Chinese health officials have reported hundreds of infections with 2019-nCoV in China, including outside of Hubei Province. Infections with 2019-nCoV also are being reported in a growing number of countries internationally, including the United States, where the first 2019-nCoV infection was detected in a traveler returning from Wuhan on January 21, 2020. …
“Coronaviruses are a large family of viruses, some causing illness in people and others that circulate among animals, including camels, cats and bats. Rarely, animal coronaviruses can evolve and infect people and then spread between people such as has been seen with MERS and SARS. …Both MERS and SARS have been known to cause severe illness in people. The situation with regard to 2019-nCoV is still unclear. While severe illness, including illness resulting in a number of deaths has been reported in China, other patients have had milder illness and been discharged.”
“Some viruses are highly contagious (like measles), while other viruses are less so. It’s not clear yet how easily 2019-nCoV spreads from person-to-person. It’s important to know this in order to better assess the risk posed by this virus. While CDC considers this is a very serious public health threat, based on current information, the immediate health risk from 2019-nCoV to the general American public is considered low at this time. Nevertheless, CDC is taking proactive preparedness precautions.”
Timeline of an epidemic
In the 21st century, epidemics are a race between the disease’s ability to spread and scientists’ efforts to identify and combat it. Modern transportation allows diseases to quickly spread globally. But modern communications and effective government agencies can react even faster, once alerted. This radically changes the nature of epidemics. This fantastic speed plus modern tech makes our response far more effective than in the early 1950s polio epidemic – and beyond anything imaginable during the 1918 influenza pandemic.
See the Wikipedia Timeline page for updates.
8 December 2019 – First case detected, although doctors did not know what it was.
30 December – An “urgent notice on the treatment of pneumonia of unknown cause” was issued by the Medical Administration and Medical Administration of Wuhan Municipal Health Committee. Hong Kong, Macau, and Taiwan tighten their inbound screening.
2 January – The WHO activated its incident management system at all three levels: national, regional, and headquarters.
3 January – Thailand and Singapore began screening inbound passengers.
5 January – Researchers ruled out seasonal flu, SARS, MERS, and bird flu as the cause. The number of suspected cases reached 59 with seven in a critical condition. All were quarantined and 163 contacts commenced monitoring. As yet, there were no reported cases of human-to-human transmission or presentations in healthcare workers.
6 January – The US CDC issued a travel watch at Level 1 (“Practice usual precautions”) for China.
7 January – CDC established a 2019-nCoV Incident Management group.
8 January – The CDC began alerting clinicians to watch for patients with respiratory symptoms and a history of travel to Wuhan.
9 January – Chinese investigators isolated a novel coronavirus from an infected patient. The first death occurred, a 61-year-old man with severe preexisting health problems.
10 January – Four groups of Chinese researchers post genetic sequences of the virus.
13 January – First reported case outside China, a 61 year-old-woman who arrived in Bangkok on January 8.
14 January – First reported case of probable human-to-human transmission of the virus.
15 January – Second death: a 69-year-old man in China.
16 January – Second case outside China: 30-year-old male Chinese national in Japan.
17 January – The CDC issued an updated interim Health Alert Notice (HAN) Advisory to inform state and local health departments and health care providers about this outbreak. It began screening of passengers on flights from Wuhan to five major US airports.
19 January – First two confirmed cases in China outside Wuhan: one in Guangdong province and two in Beijing. Third fatality. The number of laboratory-confirmed cases in China is 201.
20 January – First confirmed cases in South Korea and Shanghai. China’s National Health Commission confirmed that the coronavirus can be transmitted between humans. CDC releases a specific diagnostic test for the virus that uses a real-time reverse transcription-polymerase chain reaction (rRT-PCR). US researchers are growing the virus in cell cultures for further study.
21 January – Taiwan and the US (Washington) report their first cases. The US patient was quickly identified as a possible risk, isolated, and tested (details here). The CDC activates its Emergency Response System to support its response to 2019-nCoV, and deploys a team to Washington.
22 January – The World Health Organization holds an emergency meeting to determine if the virus is a “public health emergency of international concern (PHEIC)“. See the result below. The total number of laboratory-confirmed cases in China is 571, with a death toll of 17. China imposes a quarantine on Wuhan, although it is only slowly enforced.
23 January – CDC raises its travel alerts for China.
24 January – Provinces and municipalities and China begin declaring a level 1 public health emergency. More areas in China are quarantined. The first case reported in Europe (in France). A second case was reported in the US. To date, the CDC has investigated 63 people in 22 states: 2 have tested positive and 11 negative. They believe the virus’ incubation period is roughly two weeks. Dr. Nancy Messonnier said it is “premature to conclude that we know whether it is more or less infectious than SARS and more or less severe than SARS.”
The World Health Organization’s verdict, so far
For details about the epidemic see the WHO’s January 23 report.
“Twenty five percent of confirmed cases reported by China have been classified by Chinese health authorities as seriously ill (from Wubei Province: 16% severely ill, 5% critically ill, and 4% having died).”
Their bottom line: “WHO assesses the risk of this event to be very high in China, high at the regional level and moderate at the global level.” The WHO developed a large package of protocols for surveillance, diagnosis, control, and treatment of cases. These embed the world’s accumulated knowledge, so that each nation need not prepare by themselves. They also coordinate the exchange of information.
The International Health Regulations (2005) Emergency Committee met on January 23-24. Here is the press release.
“Research gives a preliminary R0 estimate of 1.4-2.5. …Of confirmed cases, 25% are reported to be severe. The source is still unknown (most likely an animal reservoir) and the extent of human-to-human transmission is still not clear.”
The R0 (a measure of contagiousness) number gets attention but is probably of little use for laypeople. Wikipedia gives a good introduction to it. The CDC often cites a paper saying that it is “easily misrepresented, misinterpreted, and misapplied.”
The Committee concluded that it is too early to declare a “public health emergency of international concern (PHEIC).” They will meet again in ten days, or earlier if warranted by events.
As usual, extreme views get more attention
While agencies (eg, WHO, CDC) make careful statements about the coronavirus, too many experts talk like it’s the Black Death. Wild speculation about worst-case scenarios. For example, see this. This gets them their 15 minutes, but feeds public hysteria. This has begun happening with every epidemic. We could get a “boy who cried wolf” effect, hampering the response to a major pandemic.
As an example, it takes just one paper to get people excited. Such as “Novel coronavirus 2019-nCoV: early estimation of epidemiological parameters and epidemic predictions” by Jonathan Reed et al., a non-peer-reviewed paper posted at medRxiv. Although speculative and contrary to information from the world’s public health agencies, some take it as gospel and have extreme reactions. This is what America’s liberals see today at Naked Capitalism.
Extreme libertarians tell us that governments can’t do anything right, and that we should “starve the beast.” Conservatives also hate the UN. Here we see an example of strong government agencies – national and international – providing a vital service. These are underfunded, as a horrific pandemic would reveal.
For More Information
- See the ugly cost of the next big flu pandemic. We can do more to prepare.
- Stratfor: The superbugs are coming. We have time to prepare.
- Posts debunking the hysteria about the 2009 swine flu in America.
- Posts debunking the hysteria about the 2015 ebola epidemic in America.
A great film about epidemics in the 21st century
This shows the progress of a pandemic from patient Zero, through global devastation, to eventual victory by the world’s scientists. From the studio …
“When Beth Emhoff (Gwyneth Paltrow) returns to Minnesota from a Hong Kong business trip, she attributes the malaise she feels to jet lag. However, two days later, Beth is dead, and doctors tell her shocked husband (Matt Damon) that they have no idea what killed her. Soon, many others start to exhibit the same symptoms, and a global pandemic explodes. Doctors try to contain the lethal microbe, but society begins to collapse as a blogger (Jude Law) fans the flames of paranoia.
Updates from comments of original article.
Update from the WHO on Jan 25
A total of 1,320 confirmed cases have been reported for novel coronavirus (2019-nCoV) globally.
Of the 1,320 cases reported, 1,297 cases were reported from China, including Hong Kong, Macau, and Taipei. A total of 1,965 suspected cases have been reported from 20 Chinese provinces, regions and cities (excluding Hong Kong, Macau, and Taipei).
23 confirmed cases have been reported outside of China in nine countries. Of these 23 confirmed cases, 21 had travel history to Wuhan City, China; one case in Australia had direct contact with a confirmed case from Wuhan while in China; and one confirmed case in Viet Nam had no travel history to any part of China (it is transmission within a family).
Of the 1,287 confirmed cases (excluding Hong Kong, Macau, and Taipei), 237 cases have been reported as severely ill.
41 deaths have been reported to date (39 deaths in Hubei province, one death in Hebei province and one in Heilongjiang province).
On 25 January, the number of reported confirmed cases of 2019-nCoV has increased by 474 cases since the last situation report published on 24 January.
WHO’s assessment of the risk of this event has not changed since the last update (22 Jan): very high in China, high at the regional level and moderate at the global level.
Update from the CDC
Five confirmed cases in four States of the US (AZ, CA, IL, WA). All were travelers from Wuhan. Summary:
“While CDC considers this is a very serious public health threat, based on current information, the immediate health risk from 2019-nCoV to the general American public is considered low at this time. Nevertheless, CDC is taking proactive preparedness precautions.”