Within three weeks of identifying the first case, Chinese officials had reported a new respiratory illness to the World Health Organization. Scientists identified the coronavirus a week later on Jan. 7. The country’s response to the new strain of viral pneumonia reveals the ways China—and the rest of the world—has improved responses to public health threats.
The first documented cases of the new coronavirus appeared in late December. Though the cause is still unknown, Chinese officials traced the virus to the Huanan seafood market in the central Chinese city of Wuhan. The market sold wild animals, suggesting the illness spread from an animal host to people. But it soon began to jump between humans.
On Jan. 30, the World Health Organization declared the new coronavirus, 2019-nCoV, a global health emergency. The disease has infected at least 28,200 people around the world and killed more than 560, virtually all in China. Officials have reported cases in more than two dozen countries, with one death in the Philippines and another in Hong Kong.
The severity of the coronavirus, which causes fever, cough, and shortness of breath, remains unclear and ranges anywhere from mild symptoms to death. According to the U.S. Centers for Disease Control and Prevention, the illness may manifest anywhere from two to 14 days after exposure. People may become contagious before they develop any symptoms, making it more difficult to contain.
China’s public health response has improved dramatically since the outbreak of SARS (severe acute respiratory syndrome), which infected more than 8,000 people and claimed the lives of 774 in 26 countries over nine months in 2002 and 2003. During that outbreak, Chinese officials did not report the disease until months after it first appeared. By then, five people had died and 300 were infected in China’s Guangdong province. It took another five months before American and Canadian scientists could identify the virus’s genome.
This time around, China quickly moved to quarantine millions of residents and alert international health authorities of the threat. Since the SARS outbreak, China has also updated its anachronistic system of reporting infectious diseases on handwritten filing cards and faxing them to a central office. Health officials now use a centralized online system that links clinics and hospitals across the country to report new cases in real time.
WHO Director-General Tedros Adhanom Ghebreyesus said the agency is confident in China’s capacity to control the outbreak. “Our greatest concern is the potential for the virus to spread to countries with weaker health systems and which are ill-prepared to deal with it,” he said.
But some international scientists fear China still may have transparency issues. Following the SARS epidemic, the Chinese government tightened its grip on the flow of information, and many are concerned that more people in the country have contracted the coronavirus than reported. Li Wenliang, a doctor in Wuhan, received a severe reprimand from Chinese officials after warning on social media that doctors had diagnosed seven patients from a local seafood market with a SARS-like illness and quarantined them in his hospital, CNN reported. The same day, the Wuhan Municipal Health Commission warned the city’s medical institutions that “any organizations or individuals are not allowed to release treatment information to the public without authorization.” Li, while helping others, contracted the coronavirus, and the Wuhan Central Hospital announced on Thursday he had died.
Researchers are racing to develop a vaccine for the virus. According to media reports, doctors in Thailand claim to have successfully treated one patient suffering a severe case with a combination of antiviral drugs used to treat HIV and influenza. The 71-year-old patient from China improved and tested negative for the virus within 48 hours.
In addition to China, other countries, including Germany, Japan, Thailand, and the United States, have reported human-to-human transmission of the virus, according to Tedros. So far in the United States, cases are contained to people who were in contact with the seafood market or were close to someone who was. The disease has not yet spread in the general community, and the CDC believes the risk remains low. Across the country, 11 patients have tested positive for the illness: six in California, two in Illinois, and one each in Washington, Arizona, and Massachusetts, according to the CDC.
Coronaviruses are a family of illnesses common in many different species of animals, including camels, cattle, cats, and bats. A genetic study published on Jan. 30 in The Lancet found that 2019-nCoV most closely resembles two SARS-type coronaviruses that infect bats and likely emerged in humans recently. But, according to the scientists, even though bats likely were the original host, one of the wild animals sold at the seafood market probably served as an intermediary that enabled the virus to jump to humans. Officials first reported the outbreak in late December, when most of the bat species in Wuhan hibernate. The seafood market did not sell any bats but did carry many mammals and snakes.
“This again highlights the hidden virus reservoir in wild animals and their potential to spill over into human populations,” the study’s researchers said.