As COVID-19 continues its silent and sometimes deadly march across the world, what can be learned from those uncertain, early days when it first made an appearance at a food market in Wuhan, China? People, understandably, have questions.
Will you get coronavirus? Will it kill you? Why has the Centers for Disease Control and Prevention and the U.S. government taken so long to issue testing kits so people who are asymptomatic and/or have mild systems can get tested?
As COVID-19 continues its silent and sometimes deadly march across the world, what can be learned from those uncertain, early days?
As of Sunday evening, there were 169,387 confirmed cases globally and 6,513 deaths, according to data the latest rally from the database of Johns Hopkins University’s Center for Systems Science and Engineering; the database also reported 77,257 recoveries. The U.S. has had at least 3,774 confirmed coronavirus cases and 69 deaths.
President Trump and Vice President Mike Pence on Saturday indicated that he may take similar actions to China, and impose a domestic travel ban within the U.S., particularly to/from areas that have particularly hard hit by COVID-19. “We’re working with the states, and we’re considering other restrictions,” Trump said.
Trump has already imposed a month-long travel ban on 26 European countries and, on Saturday, extended that ban to the U.K. and Ireland. U.S. citizens, green-card holders and others are still allowed to return home to the U.S., but will be directed through 13 airports and will have to undergo health screenings and quarantine.
Also see: Influenza kills more people than the flu so everyone is overreacting, right? Wrong — here’s why
Silence and misinformation helped the virus spread
The Centers for Disease Control has been keeping a close track of the number of cases, and their location, and the government has taken relatively swift action, in sharp contrast to the Aids crisis in the 1980s.
China did not appear to take early, preemptive actions. It was far less reluctant to tell its citizens about the suspected virus in those early days last December. The first known person was reported to have contracted the virus on Dec. 1 in China, according to an article in The Lancet.
The early spread of the disease was likely helped by preparations for China’s Lunar New Year holiday, when people traveled to visit relatives. Wuhan mayor Zhou Xianwang said 5 million people had left the city before travel restrictions were imposed ahead of the Lunar New Year.
Last December, Yaxue Cao, the founder of the political pressure group ChinaChange.org, wrote on Twitter TWTR, +9.37% that a Wuhan doctor had posted in a WeChat group to say there were seven cases of SARS connected to the food market. He was scolded by the party disciplinary office, and forced to retract that, Cao said. That doctor later died from COVID-19.
Amid the fear and confusion surrounding the initial days of the virus in China, some families there 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 challenge that we have is that very soon the southern hemisphere will move into winter, when we move to summer.’
Such practices may have delayed news and/or awareness of the outbreak, which is why the media and public-health authorities are ramping up efforts to encourage people to wash their hands for 20 seconds and cover their mouth if they sneeze and cough.
“COVID-19 rapidly spread from a single city to the entire country in just 30 days,” a Feb. 24 paper on the fatality rates of the disease in the peer-reviewed medical journal JAMA found. “The sheer speed of both the geographical expansion and the sudden increase in numbers of cases surprised and quickly overwhelmed health and public-health services in China.”
“It’s not surprising that it happened in the winter season,” said Jeff Goad, a professor and chair of the Department of Pharmacy Practice at Chapman University, a private university in Orange, Calif. “Illnesses that are respiratory in nature tend to spread faster in colder environments. People are indoors more often and they congregate more.”
Coronavirus is believed to have originated at a food market in Wuhan, China. In January, Zhou Xianwang, the mayor of Wuhan, said 5 million people left the city before travel restrictions were imposed ahead of the Lunar New Year.
The U.S. has not taken that approach: Restaurants are closing. Music festivals and sporting events have canceled. Broadway has gone dark. People are being told to work from home and practice “social distancing” of at least six feet and wash their hands regularly with soap for at least 30 seconds.
China has introduced mobile testing centers across the country. The U.S. government has been criticized for not rolling out testing nationwide sooner.
Some critics have said that the Chinese government could have done more in those early days to alert authorities to both the existence of the virus and confirm that human-to-human transmission was likely, especially when hospitals in Wuhan were seeing more and more people arriving at their doors, complaining about the same symptoms.
However, China has since put many cities on lockdown and has introduced mobile testing centers across the country, so people who may have a cough, fever, sore throat or other symptoms will get tested and avoid spreading the virus and self-quarantine, if the test comes back positive.
The U.S. government has been criticized for not rolling out testing nationwide sooner. “Americans need access to rapid diagnostic testing,” Rick Bright, director of the government’s Biomedical Advanced Research and Development Authority, told NPR on Friday.
“The sooner clinicians, patients and public health officials know whether someone is infected with the novel coronavirus, the sooner they can take action to mitigate the spread of COVID-19. “Rapid diagnostic tests are critical in this public health response,” he added. “We are working with the private sector at an urgent pace to make these tests available on as many diagnostic platforms as we can in the coming weeks.”
However, the World Health Organization’s decision to declare COVID-19 a worldwide epidemic confirms most infectious-disease doctors’ worst fears, that this is now a matter of containment rather than prevention.
“Unfortunately, the virus is very effective, just like the influenza virus,” Goad said. “The challenge we have is that, very soon, the southern hemisphere will move into winter, when we move to summer,” he said. “If we have some of the travel restrictions in place in the summer months, it may hopefully curb some of the spread between hemispheres.”
“It may slow it down,” he added, “but it’s unlikely to stop it.”
Here’s a timeline of events in the early stages of the COVID-19 outbreak
Dec. 1: The first known patient to have contracted the virus is identified in Wuhan, according to a boots-on-the-ground investigation by a group of Chinese researchers published in the medical journal The Lancet. “None of his family members developed fever or any respiratory symptoms. No epidemiological link was found between the first patient and later cases,” they wrote.
Dec. 18: Ai Fen, the head of the emergency department at Wuhan Central Hospital, says shenoticed an elderly man with a lung infection, high fever and flu-like symptoms.
Late December: A Wuhan doctor posts in a WeChat group that there were seven cases of what he describes as SARS connected to the food market. At the behest of the local Communist party office, he later signs a document at a local police station saying he made an error.
A potluck banquet was held on Jan. 20 for 40,000 families from a precinct in Wuhan, the epicenter of the outbreak.
Dec. 31: Authorities inform the WHO China Country Office of cases of pneumonia of unknown etiology (unknown cause) detected in Wuhan.
Jan. 1: The food market in Wuhan, the epicenter of the coronavirus outbreak, closes for environmental sanitation and disinfection. WHO requests further information from China.
Jan. 7: Chinese scientists say they’ve identified a new virus that, like SARS and the common cold, belongs to the coronavirus family. Chinese President Xi Jinping issues orders to contain the new coronavirus, according to Qiushi, the official Communist party magazine; previous reporting by Chinese state media gave Jan. 20 as the date the president issued those orders.
Jan. 11: China announces the first known death from the coronavirus: a 61-year-old man who had bought food at the Wuhan market. WHO receives “detailed information” from Chinese authorities that there is “no clear evidence of human-to-human transmission” linked to coronavirus cases found.
Jan. 15: Wuhan’s health commission releases a statement: “The possibility of limited human-to-human transmission cannot be ruled out.”
Jan. 18: An annual potluck banquet is held for 40,000 families from a city precinct in Wuhan.
Wuhan’s mayor said 5 million people left the city before travel restrictions were imposed ahead of the Lunar New Year.
Jan. 20: Chinese officials say the coronavirus, which initially spread from an animal or animals to people, can be transmitted through human-to-human contact.
Jan. 23: Public transport on buses, trains and ferries in Wuhan are suspended from 10 a.m. local time to help prevent the spread of the virus.
Jan. 24: WHO says it’s too early to declare a “public-health emergency of international concern,” its highest alert. Coronavirus makes its first official appearance in Europe, with French authorities confirming three cases of the virus. Australia confirms four people with the virus.
Jan. 25: Pared-down Lunar New Year celebrations begin with many of the festivities canceled.
Jan. 29: The New England Journal of Medicine says: “There is evidence that human-to-human transmission has occurred among close contacts since the middle of December 2019.”
Jan. 30: As the virus spreads internationally, the WHO’s Tedros declares the coronavirus a public-health emergency of international concern.
Feb. 2: The first official death from COVID-19 outside of China is reported in the Philippines: a 44-year-old Chinese man who arrived in Manila from Wuhan.
Feb. 7: Dr. Li Wenliang, 34, the doctor who first sounded the alarm on the virus in an online chat group with other doctors, dies. The hospital where he worked makes the announcement.
How COVID-19 is transmitted
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