China Virus: A 20-Day Special Review
Ma Xiaohua
DATE:  Jan 22 2020
/ SOURCE:  yicai
China Virus: A 20-Day Special Review China Virus: A 20-Day Special Review

(Yicai Global) Jan. 21 -- Twenty days on from the outbreak of a new deadly coronavirus that began in the Chinese city of Wuhan at the very end of last year, Yicai Global has reviewed the information released and prevention and control measures taken since Dec. 31.

As of 12.48 p.m. today, China has reported a total of 233 cases of the new infection, including 219 confirmed and 14 suspected, according to official information. Four deaths have also been reported. Apart from incidences in China, one confirmed case has been reported in Japan, two in Thailand, and one in South Korea.

> Dec. 30, 2019
An Urgent Notice on Treatment of Pneumonia from Unknown Causes was issued by the Wuhan Municipal Health Commission and circulated on the internet. The notice stated that some medical institutions in Wuhan had patients with pneumonia from unknown causes, and ordered medical institutions to do a good job on treating them.

This was the earliest sign of the so-called Wuhan pneumonia.

> Dec. 31, 10.00 a.m.*
Yicai Global published an exclusive report on the Wuhan pneumonia, saying the city had isolated infected people and would release test results as soon as possible.

> Dec. 31, 1.00 p.m.
The Wuhan Municipal Health Commission issued its first report. Some medical institutions found that many of the pneumonia cases were related to Wuhan's Huanan Seafood Market and reported 27 cases, of which seven were in severe condition while the others were stable and controllable. Two patients had improved and were to be discharged soon.

After consultations with professionals in clinical medicine, epidemiology and virology, experts said that the cases pointed to viral pneumonia, which was the first recognition of Wuhan pneumonia. They said that there was no obvious human-to-human transmission and no medical worker had been infected.

The Huanan Seafood Market was not closed.

> Dec. 31, 1.00 p.m.
A Yicai Global reporter went to the market and observed that stalls were operating normally. Only a few shops were closed and few people wore masks. A vendor told the reporter that the market was undertaking regular disinfection, and not necessarily because of the pneumonia.

> Jan. 3
The Wuhan Municipal Health Commission issued a second report. As of 8.00 a.m., a total of 44 patients with viral pneumonia from unknown causes were found in the city, including 11 critically ill patients.

> Jan. 5
The Wuhan Municipal Health Commission issued a third report. As of 8.00 a.m., the city reported a total of 59 viral pneumonia cases from unknown causes, including seven critically ill patients. The number of patients was rising. The conclusion of the report maintained that "preliminary investigations show no clear evidence of human-to-human transmission and no medical workers have been infected."

As for the virus itself, the report explicitly said that respiratory pathogens, including influenza, avian influenza, adenovirus, Severe Acute Respiratory Syndrome (SARS) and the Middle East Respiratory Syndrome (MERS), had been ruled out. Pathogen identification and tracing of the cause were still under way.

The report also clearly said that the cause of the Wuhan pneumonia was a new virus not yet recognized.

"The virus that causes the Wuhan pneumonia may come from wild animals," a virology expert told Yicai Global. "The Huanan Seafood Market sells wild animals, and Wuhan is a habitat for migratory birds. The mixing of viruses in wild animals here can happen at any time."

> Jan. 11
The Wuhan Municipal Health Commission issued a fourth report stating that the pathogen of the unknown viral pneumonia was initially identified as a new coronavirus.

The fourth report stated that, as of midnight on Jan. 10, Wuhan had 41 confirmed cases of the new coronavirus pneumonia, of which two patients were discharged, seven were severely ill, and one had died. The rest were in stable condition. All 739 people in close contact with the patients, including 419 medical workers, had been put under medical observation and no related cases were found.

The official report still insisted that no medical staff infection nor clear evidence of human transmission were found.

Notifications did not change until Jan. 14, when the Wuhan Municipal Health Commission issued its seventh notice, saying a total of 41 new coronavirus-related pneumonia cases had been reported in the city, seven of them had been cured and discharged, six were serious and under treatment, and one had died. Thailand diagnosed one case originating from Wuhan.

The epidemic situation had changed in the notification from "no obvious evidence that the pneumonia can spread from human to human" to "the possibility of limited transmission between humans cannot be ruled out."

Existing investigation showed that no clear evidence of human-to-human transmission has been found, and the possibility of limited human-to-human transmission cannot be ruled out, but the risk of continued human-to-human transmission is low, the notification stated. Of the 41 confirmed cases, a couple was diagnosed with the husband infected earlier than the wife. He worked at the Huanan Seafood Market, but his wife denied ever having been there.

"The case of family members infected indicates the pneumonia can spread from human to human, and about 20 percent of the cases are severe, so we must take measures to prevent and control the pneumonia as a severe infectious disease," an epidemiologist said.

The epidemic prevention and control, however, didn't change greatly in the case of the family members infected and the Thai patient. The only change was that the following sentence was deleted in subsequent notifications: No medical staff have been infected, and no firm evidence of human-to-human transmission has been found.

The epidemic continued to spread.

> Jan. 21
The Beijing Daxing District Health Commission and the Health Commission of Guangdong Province separately issued notices about diagnosed cases. Daxing confirmed two cases, and Shenzhen in Guangdong confirmed one case.

President Xi Jinping gave important instructions on the pneumonia. The safety and health of the people must be the first priority, and we must do our best to curb the spread of the epidemic, he said. Premier Li Keqiang presided over an executive meeting of the State Council, China's cabinet, to make further arrangements for pneumonia prevention and control and demanded effective and efficient measures to contain the epidemic.

An interview with a high-level experts' team, organized by the National Health Commission, was released later. Zhong Nanshan, head of the team, confirmed the pneumonia can spread from human to human and that medical staff had been infected.

The Chinese New Year travel rush has begun, and the number of people leaving Wuhan has multiplied as usual. "There is no vaccine for the pneumonia for now," a local disease control officer not from Hunan said. "The first line of defense is health education and self-protection.

"Patients must go to hospital for treatment, and suspicious cases must be reported to the disease control agency for tests," he said. "Confirmed cases must be isolated and treated in hospital, and the disease control agency should put those in close contact with the patients in quarantine and keep an eye on them and conduct related environmental disinfection. Hospitals are the first place to identify patients."

The epidemic is now in the initial phase, and prevention and control must be strengthened so that everyone knows, Zeng Guang, a member of the NHC's high-level expert team, noted, saying that the flow of population during the Spring Festival, as Chinese New Year is known in the country, is a very important factor. He hoped that people won't go to or leave Wuhan unless necessary.

However, with the Chinese New Year approaching, Wuhan is now in the peak period of people departing and returning to the city. According to information released by the Wuhan public security and transport authority on Jan. 18, the peak congestion delay index around Wuchang and Hankou stations rose 15.3 percent and 10.5 percent, respectively, from the previous month, while the peak congestion delay index around Wuchang Station and Hongji Terminal climbed 26.3 percent from the previous week, up 24.8 percent from the same period last month.

Some 2.3 million travelers left Wuhan during the Spring Festival in 2018, according to data released by the Wuhan Culture and Tourism Bureau.

"The median incubation period for this virus is nine days," an epidemiologist warned. "The current testing equipment can only monitor patients with fever, but cannot identify the virus' carriers. More provinces may find new cases due to the population movement."

The annual Spring Festival's travel peak is fast approaching. With hundreds of millions of people either returning home or traveling, the battle to prevent and control this potent contagion is entering its most difficult and critical phase.

*All times are China local time.

Editors: Chen Juan, Peter Thomas

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Keywords:   WuhanPneumonia