The death toll from coronavirus keeps climbing.
There are now 37,198 confirmed cases of coronavirus worldwide and at least 811 people have died, according to the latest figures from China’s National Health Commission released Sunday; 89 deaths and 2,656 new cases were reported over the previous 24-hour period.
It has now killed more people than SARS (774), although the fatality rate for coronavirus (2.1%) is still far lower than that of SARS (9.6%).
The majority of illnesses and deaths are in Hubei Province where Wuhan — believed to be the epicenter of the outbreak — is located. There are 12 confirmed cases in the U.S., according to the Centers for Disease Control and Prevention. The illness has now spread to 25 countries. (The World Health Organization has declared a global health emergency.)
An additional 14 Americans were confirmed to have contracted the virus, NBC News reported, citing Japan’s health ministry; they are passengers on the quarantined cruise ship, the Diamond Princess, which arrived at a port in Yokohama, Japan on Sunday morning. One of those cruise ship passengers is a woman in her 70s who has joint Hong Kong residency and U.S. citizenship. Several cruise lines have issued quarantines for ships currently at sea, and have tested passengers for coronavirus.
The virus has spread to 25 countries, although the majority of illnesses and deaths are in Hubei Province, which is where Wuhan, believed to be the epicenter of the virus, is located.
A 60-year-old American woman in Wuhan was the first U.S. citizen to die of the coronavirus on Thursday, the U.S. embassy in Beijing said. “We offer our sincerest condolences to the family on their loss,” the embassy said in an emailed statement. “Out of the respect for the family’s privacy, we have no further comment.”
According to the CDC, there are confirmed cases in more than two dozen countries or territories, including Germany, Australia, Japan, Vietnam, Russia, the U.K. and the U.S.
Local media reports have suggested that the infection tally could be even higher than the latest official number. Adding to that fear and confusion, some families in China have voiced concern and frustration that their relatives’ cause of death was marked as “severe pneumonia” or “viral pneumonia” on their death certificates, The Wall Street Journal reported.
The outbreak has spread rapidly over the last several weeks. It is believed to have originated at a food market in Wuhan. Last month, Zhou Xianwang, the mayor of Wuhan, said that 5 million people had left the city before travel restrictions were imposed ahead of the Chinese New Year. China also said that it will refurbish and re-open the Xiaotangshan Hospital on the outskirts of Beijing, built during the 2002-2003 SARS outbreak.
A study published in the medical journal JAMA on Friday suggests a higher fatality rate, and suggests some patients may be more contagious than others. One patient spread the virus to at least 10 health-care workers and four patients at the hospital.
“In this single-center case series of 138 hospitalized patients with confirmed novel coronavirus–infected pneumonia in Wuhan, China, presumed hospital-related transmission of 2019-nCoV was suspected in 41% of patients, 26% of patients received ICU care, and [the] mortality was 4.3%.”
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In an effort to stem the spread of the virus from its suspected origin, transport bans were instituted in 16 cities with a combined population of 50 million people. Officials in Wuhan, a city with 11 million residents, said they had temporarily closed the area’s outgoing airport and railway stations, and suspend all public transport. Long-distance trains and buses from Huanggang, a neighboring city with 7.5 million people, stopped running indefinitely last month.
Human intervention, or lack thereof, may also have been a factor. More than half a dozen doctors first discussed the threat of a potential coronavirus outbreak in early December only to be silenced by the local Communist Party, according to some critics of the government.
Yaxue Cao, founder and editor of the political pressure group ChinaChange.org, said a Wuhan doctor posted in a WeChat group to say there were seven cases of SARS connected to the seafood market. He was then scolded by the party disciplinary office, and forced to retract that, Cao said.
“From the same report, we learned that Wuhan health authorities were having overnight meetings about the new ‘SARS’ at end of December,” Cao posted on Jan. 27. “Earlier today. the Wuhan mayor said he was not ‘authorized’ to publicize the epidemic until Jan. 20.”
Dr. Li Wenliang, 34, the doctor who first sounded the alarm on the virus, died, worked at a hospital in the epicenter of the outbreak in the central city of Wuhan, the hospital announced on Feb. 7.
“Our hospital’s ophthalmologist Li Wenliang was unfortunately infected with coronavirus during his work in the fight against the coronavirus epidemic,” the hospital said. “He died at 2:58 a.m. on Feb. 7 after attempts to resuscitate were unsuccessful.”
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The spread was likely helped by China’s Lunar New Year holiday last month. Wuhan mayor Zhou Xianwang said 5 million people had left the city before travel restrictions were imposed ahead of the Chinese New Year.
“People unfamiliar with China have trouble understanding the immense travel phenomenon that occurs during Lunar New Year, when, over a one-month period, some 3 billion people are on the move, many returning to their home towns and regions but others vacationing,” Tanner Brown, a Beijing-based journalist, wrote for MarketWatch last month. “Peak travel occurs this week.”
The virus has spread in China, helped by the country’s Lunar New Year holiday.
Another potential reason for the rapid spread: While some people are canceling travel plans in China and opting to stay home over the holiday period, others may not yet have experienced the worst of the symptoms, believe themselves to be well enough to travel and/or could be reluctant to pay up to $400 to change a flight — especially if they believe they merely have a common cold. In fact, previous iterations of the coronavirus have caused illnesses very similar to a common cold.
People also may not know they’re carrying the virus. Symptoms of common human coronaviruses include a runny nose, headache, cough, sore throat, fever and a general feeling of being unwell, according to the CDC. Symptoms of the new coronavirus can include fever, cough and shortness of breath.
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Ma Xiaowei, the director of China’s National Health Commission, said that the virus had an incubation period of up to 14 days, during which the virus can be contagious but the patient does not display symptoms. That, medical professional say, may allow the virus to be passed along from person to person. (SARS has an average incubation rate of 2 to 7 days, according to the CDC.)
“From observations, the virus is capable of transmission even during incubation period,” Ma said during a news conference, according to a report in the South China Morning Post. “Some patients have normal temperatures and there are many milder cases. There are hidden carriers.”
Previous iterations of the coronavirus are very similar to a common cold.
But more severe coronaviruses can become more serious and progress to pneumonia. “Human coronaviruses can sometimes cause lower-respiratory tract illnesses, such as pneumonia or bronchitis,” the CDC added. “This is more common in people with cardiopulmonary disease, people with weakened immune systems, infants, and older adults. Two other human coronaviruses, MERS-CoV and SARS-CoV, have been known to frequently cause severe symptoms.”
There is still much that is unknown about coronavirus, including how long it can last for any period of time outside of the host. “It’s currently unclear if a person can get 2019-nCoV by touching a surface or object that has the virus on it and then touching their own mouth, nose, or possibly their eyes,” the CDC says.
Other bugs can last on objects for days. The Methicillin-resistant Staphylococcus aureus (more commonly known as MRSA) lasted longest (168 hours) on material from a seat-back pocket while the bacteria Escherichia coli O157:H7 (also known as E.coli, which can cause kidney problems) survived longest (96 hours) on the material from the armrest of planes, according to research presented in 2014 to the American Society for Microbiology.
Office workers pick up 30% to 50% of the organisms that are left on surfaces.
Last week, the Trump administration announced that foreign nationals who had visited China within the past 14 days would be barred from entering the U.S., while Americans who visited the Chinese province at center of outbreak would be quarantined upon their return to the U.S. Several U.S. airlines suspended flights to China.
But it was weeks since the virus was first discovered before flights were curtailed, and the global travel industry is ideal for many viruses to travel long distances.
In an attempt to remain competitive, airlines have decreased their turnaround times in recent years. Many budget airlines have reduced turnaround times to 25 minutes by removing the seat pockets. Other airlines have managed to have long-haul turnaround times of 90 minutes. Not only do planes get a new plane load of passengers, they often get a completely different crew.
Deep cleans are not always possible during such turnarounds. Charles Gerba, a microbiologist at the University of Arizona, recommends using hand sanitizers or disinfectant wipes, particularly when traveling and/or at the office, where people may be reluctant to stay home if they’re sick.
A study published in the Lancet last month looking at five of six family members with the coronavirus said that it’s spreading from person to person, rather than exclusively from animals or infected food, and can be transmitted in social, family and even hospital environments. “This is a novel coronavirus, which is closest to the bat severe acute respiratory syndrome (SARS)-related coronaviruses found in Chinese horseshoe bats,” the study said.
(This story was updated on Feb. 9.)
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