How China’s coronavirus outbreak started, explainedMegan Orito
How China’s coronavirus outbreak started, explained.
Credit – Betsy Joles / Stringer / Getty Images
On December 31, 2019, the World Health Organisation’s (WHO) China office heard the first reports of a previously-unknown virus behind a number of pneumonia cases in Wuhan, a city in Eastern China with a population of over 11 million.
Since then, the virus has infected more than 14,200 people in mainland China, with a further 100 cases reported from 23 other countries. Although the disease is mostly confined to China, where each of its provinces and territories have reported infections, coronavirus has reached as far as the US, France, Germany, Australia, Japan, Canada and South Korea, the United Arab Emirates, the UK and Finland. At least 304 people have died in China plus one person outside of China – a 44-year-old man in the Philippines who was a resident of Wuhan and died on Saturday, February 1.
The Chinese government has responded to the outbreak by placing Wuhan and nearby cities under a de-facto quarantine encompassing over 30 million people. In the UK, British Airways has suspended all direct flights to China, while Hong Kong has suspended trains and halved the number of flights travelling to the region from the Chinese mainland.
On Thursday, January 30, the WHO officially designated coronavirus a “public health emergency of international concern” (PHEIC), indicating that international action will be required to contain the outbreak. In the past decade, only five other PHEIC announcements have been made.
How did the coronavirus start?
The virus appears to have originated from a Wuhan seafood market where wild animals, including marmots, birds, rabbits, bats and snakes, are traded illegally. Coronaviruses are known to jump from animals to humans, so it’s thought that the first people infected with the disease – a group primarily made up of stallholders from the seafood market – contracted it from contact with animals.
Although an initial analysis of the virus suggested it was similar to coronavirus seen in snakes, it now seems more likely that it came from bats. A team of virologists at the Wuhan Institute for Virology released a detailed paper showing that the new coronaviruses’ genetic makeup is 96 per cent identical to that of a coronavirus found in bats. Some early cases of coronavirus, however, appear to have infected people with no link to the Wuhan market at all, suggesting that the initial route of human infection may pre-date the market cases.
The Wuhan market was shut down for inspection and cleaning on January 1, but by then it appears that the coronavirus was already starting to spread beyond the market itself. On January 21, the WHO Western Pacific office said that the disease was also being transmitted between humans – evidence of which is apparent after medical staff became infected with the virus. Cases in Taiwan, Thailand, Germany, Vietnam, Japan, France and the United States also involved patients who had not been to China, implying that there has been some human-to-human transmission outside of China.
What exactly is coronavirus?
Coronaviruses are a large group of viruses that are known to infect both humans and animals, and in humans causes a respiratory illness that ranges from common colds to much more serious infections. The most well-known case of a coronavirus epidemic was Severe Acute Respiratory Syndrome (Sars), which, after first being detected in southern China in 2002, went on to affect 26 countries and resulted in more than 8,000 cases. The number of people infected with coronavirus has now surpassed those hit with Sars.
While the cause of the current outbreak was initially unknown, on January 7 Chinese health authorities identified that it was down to a strain of coronavirus that hadn’t been encountered in humans before. Five days later the Chinese government shared the genetic sequence of the virus so that other countries could develop their own diagnostic kits.
Although symptoms of coronaviruses are often mild – including runny noses, headaches, coughs and fevers – in some cases they lead to more serious respiratory tract illness including pneumonia and bronchitis. These can be particularly dangerous in older patients, or people who have existing health conditions, and this appears to be the case with this novel coronavirus. Of five early deaths where researchers had analysed the available medical history, four of them had underlying medical conditions that may have made them more vulnerable to the virus.
How far has it spread?
China has bore the brunt of coronavirus infections (so far). As of January 31, Chinese health authorities had acknowledged over 14,200 cases and 304 deaths. Although the majority of cases are within the central Hubei province, the disease has also spread to Beijing, Shanghai and Guangdong province.
The list of other countries that have confirmed infections includes Thailand, Japan, Hong Kong, Singapore, Taiwan, Australia, Malaysia, Macau, Russia, France, the United States, South Korea, Germany, the United Arab Emirates, Canada, the United Kingdom, Italy, India, the Philippines, Nepal, Cambodia, Sri Lanka, Finland, Sweden and Spain.
In the UK, the first two coronavirus infections were confirmed on January 31. The infected people were from the same family and were taken ill while staying in a hotel in York. Work is currently underway to trace who they may have come into contact with, although the hotel itself is not thought to present a significant infection risk. Eighty-three Britons who have been evacuated from Wuhan by the Foreign Office are being held in quarantine for 14 days.
In the US, the Centres for Disease Control and Prevention has recommended against all nonessential trips to China, while the UK Foreign and Commonwealth Office is advising against all travel to Hubei Province and all but essential travel to the rest of mainland China.
On Friday, January 31, US Health Secretary Alex Azar said that foreign nationals who had travelled in China in the past 14 days would not be allowed entry to the US. New Zealand is also denying entry to foreign nationals or non-residents who are travelling to the country from mainland China or after transiting through China. These travel restrictions contradict the WHO’s latest findings, which currently do not recommend any travel or trade restrictions.
Russia, meanwhile, closed its long border with China in an effort to contain the spread of the virus. On Thursday, January 30, Prime Minister Mikhail Mishustin said the border closure would be one part of a number of measures to prevent the virus spreading in Russia, but since then the country has seen two cases of coronavirus.
What’s going to happen next?
While the number of cases in China is rising fast, there has been limited evidence of human-to-human transmission outside of China. The first confirmed cases of human-to-human transmission in Europe was reported in Germany on Tuesday, January 28, in a man who caught the virus from a Chinese colleague who visited him from Shanghai. Further cases in Taiwan, Vietnam and Japan also involved people who had not travelled to China.
After initially delaying the decision, on January 31, the WHO declared coronavirus an international public health emergency. Director-general Tedros Adhanom Ghebreyesus cited the pace of the outbreak in China and cases of human-to-human transmission outside of the country among the factors contributing to the health agency’s decision to declare an international emergency.
Since 2009, there have only been five declarations of international public health emergencies: the swine flu pandemic in 2009, a polio outbreak in 2014, the Western Africa Ebola outbreak in 2014, the Zika virus outbreak in 2015 and another Ebola outbreak in the Democratic Republic of the Congo in 2019.
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