Effects of corrona virus on the world community

On 15 January 2020, the Ministry of Health, Labour and Welfare, Japan MHLW reported an imported case of laboratory-confirmed 2019-novel corona virus 2019-nCoV from Wuhan, HubeiProvince,

EFFECTS OF CORRONA VIRUS ON THE WORLD COMMUNITY

(A Case Study of China Wuhan and Hubei Provinces)

Dr.Naushad KhanEmail:- drkhan@aup.edu.pkInstitute of Development Studies, The University of Agriculture Peshawar

Mahnoor NaushadStudent of Agriculture University Peshawar

at the Wuhan Institute of Virology led by virologist Zheng-Li Shi isolated the virus from a 49-year-old woman, who developed symptoms on 23 December 2019 before becoming critically ill Doctor, Li Wenliang

on 31 December told that an unknown virus has been developed in the province of Wuhan and Hubeiprovinces as like SARS and MERS The symptoms were found fever, throat sore and sneezing by woman in the hospital The Doctor Li has shared the knowledge on E-Chat while police department has declared the rumors against the country and told to Dr.Li to delete the said statement from the E-Chat and keep the data

in secrecy while latter on 20, January, 2020 it was announced by government media that Corona Virus has killed many people in the provinces of Wuhan and Hubei Due to late coverage in the mean time the virus was spread to the whole world which has damaged majority people in their area and emergency was announced by China and world Health Organization They have sealed majority airports and visas were cancelled by different countries in the world Globally 4594 cases of the corona Virus was confirmed China total confirmed cases number was 4537 while 6973 were suspected and 976 were found severe and 106 deaths were recorded Similarly outside of China 57 cases were confirmed and 16 countries were declared affected According to data Japan affected number was 6, Republic of Korea 4, Viet Nam 2 ,Singapore 7 Australia 5, Malaysia 4, Cambodia 1, Thailand 14, Nepal 1, Sri Lanka 1, United States of America 5 ,Canada 2, France 3, Germany 1 and Pakistan 1 World Health Organization has tried best for its controlling and the Director General did meeting with the President Xi Jiping for overcoming this problems in the emergency in china World Pathologists’ were informed for Vaccine preparation Similarly world economy

has been damaged and the economy of the China was highly affected by this virus and the new year program was halted on the spot The China has struggled best and its program was highly appreciated for this virus controlling The review further shows that the people of the China are very patriotic and they made hospital in day night for treatment of the affected people by virus The review further explains that through sneezing and human contact the virus were spread to whole community of the world So for protection purpose Wuhan and Hubei provinces were sealed for further spreading this virus Masks were prepared in for protection of community On the basis of problems the following recommendations were suggested for its controlling in future Mostly Halal food should be provided to China community in future World wise Quarantines should be developed by each country for different germs protection.; Good hospital and quality Doctors should be produced by each country; Give freedom to media for awareness of community to take action in time to protect the world from the epidemic disease; Safety net should be provided by WHO in the developing countries in time More funds should be provided to health department in the world Similarly research fund should be increased in all hospital of the world for conducting research on the medical background Testing laboratories and food inspectors should be multiplied for protection of different diseases

crisis.“Everyone is waiting to see how this evolves,” said Miguel Patricio, the chief executive officer of Kraft Heinz Co The food giant has a couple thousand employees in China, including a small sales team in Wuhan

“The danger, of course, is that if this continues and people have to stay home, then problems in terms of distribution, production will be started.” An interconnected global economy is feeling the strain of China’s viral outbreak and the potential $160 billion hit in lost growth that may be on the way Already SARS in

2003 has also disturb the economy of the China Seeing to its importance the present study was arranged to fully know the situation which is going on in China and other part of the world and to see the effects ofcorona virus on the world community

2 METHODS AND MATERIALS

The study was carried out since Feb,2020 and the major objective was that to examine the effect of the Corona Virus on the world community The main target in this study was the Wuhan and the Hubei province of China Total 14 articles were downloaded from the net and read 10 to 20 times in depth and analyzed the situation which is presently going in China

A On 15 January 2020, the Ministry of Health, Labour and Welfare, Japan (MHLW) reported an

imported case of laboratory-confirmed 2019-novel corona virus (2019-nCoV) from Wuhan, HubeiProvince, China The case-patient is male, between the age of 30-39 years, living in Japan The case-patient travelled to Wuhan, China in late December and developed fever on 3 January 2020 whilestaying in Wuhan He did not visit the Huanan Seafood Wholesale Market or any other live animalmarkets in Wuhan He has indicated that he was in close contact with a person with pneumonia On 6January, he traveled back to Japan and tested negative for influenza when he visited a local clinic onthe same day On 10 January 2020, due to his continued symptoms of cough, sore throat and fever, hevisited a local hospital and was found to have abnormal chest x-ray with infiltrates He was admitted

to the hospital on the same day and had remained febrile until 14 January On 14 January, hisattending doctor notified the case to a local public health authority under the surveillance system for

“Unidentified Serious Infectious Illness” Samples were collected and sent to the National Institute ofInfectious Diseases (NIID), and at NIID, polymerase chain reaction (PCR) testing and sequencingwas performed twice, which identified very small amount of 2019-nCoV RNA on 15 January 2020

On 15 January, the case-patient was a febrile and was discharged from hospital Currently, he isstaying at home in a stable condition Contact tracing and other epidemiological investigations are underway by the local health authorities in Japan; The Japanese Government has scaled up a whole-

of-government coordination mechanism on the 16 January; The MHLW has strengthened surveillance for undiagnosed severe acute respiratory illnesses since the report of undiagnosed pneumonia in Wuhan, China; From 6 January, MHLW requested local health governments to be aware of the respiratory illnesses in Wuhan by using the existing surveillance system for serious infectious illness with unknown etiology; NIID is supporting local authorities on epidemiologic investigations including contact tracing; Quarantine and screening measures have been enhanced for travelers from Wuhan city at the point of entries since 7 January; NIID established an in-house PCR assay for in Corona Virus on 16 January; Revision of the risk assessment by NIID is being conducted, including case definition of close contacts; The public risk communication has been enhanced; A hotline has been established among the different ministries in the government; The MHLW is working closely with WHO and other related Member States to foster mutual investigations and information sharing This was the second of three exported cases of novel coronavirus from Wuhan city, China Since the initial report of cases in Wuhan city on 31 December 2019,and as of 12 January 2020, 41 laboratory-confirmed cases of in Corona Virus infection, including 2deaths in cases with underlying medical conditions have been reported to WHO Two cases havebeen reported from Thailand The source of the outbreak is still under investigation in Wuhan.Preliminary investigations have identified environmental samples positive for in Corona Virus inHuanan Seafood Wholesale Market in Wuhan City, however some laboratory-confirmed patients didnot report visiting this market To date, there is no reported infection among healthcare workers inChina, Thailand or Japan No additional cases have been reported since 3 January in China.Additional investigations are needed to determine how the patients were infected, whether human-to-human transmission has been observed, mode(s) of transmission, the clinical spectrum of disease, andthe extent of infection, including presence of subclinical cases that are undetected with currentsurveillance It is critical to review all available information to fully understand the extent oftransmissibility between people and likelihood of zoonotic spillover Although the source of thenovel corona virus causing this cluster of pneumonia and the mode(s) of transmission are unknown, itwould be prudent to remind populations and health workers of the basic principles to reduce thegeneral risk of transmission of acute respiratory infections: Avoiding close contact with people suffering from acute respiratory infections; Frequent hand-washing, especially after direct contact with ill people or their environment; Avoiding unprotected contact with farm or wild animals; People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands); Within healthcare facilities, enhance standard infection prevention and control practices in hospitals, especially in

emergency departments; WHO does not recommend any specific health measures for travelers In case of symptoms suggestive of respiratory illness either during or after travel, the travelers are encouraged to seek medical attention and share their travel history with their health care provider Travel guidance has been updated Health authorities should work with travel, transport and tourismsectors to provide travelers with information to reduce the general risk of acute respiratory infectionsvia travel health clinics, travel agencies, conveyance operators and at points of entry WHO hasprovided interim guidance for novel corona viruses WHO advises against the application of anytravel or trade restrictions on Japan based on the information currently available on thisevent.(https://www.who.int/csr/don/17-january-2020-novel-coronavirus-japan-ex-china/en/)

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B Yan (Jan 22, 2020) told that Beijing has responded faster to the new threat than it did with SARS,

but it still silences and punishes those who veer from the official line, with potentially damaging consequences The SARS disaster was supposed to drag China into a new era of openness and responsibility The deadly disease rippled across the world 17 years ago, abetted by a Chinese government that covered up its spread As the scope of it became clear, China’s journalists, intellectuals and other critics helped shame Beijing into opening up about the problem.“SARS has been our country’s 9/11,” said Xu Zhiyuan, then a young newspaper columnist and a fierce critic of the government’s handling of SARS, in a 2003 interview with The New York Times “It has forced

us to pay attention to the real meaning of globalization.”Today, China faces the spread of anothermysterious disease, a corona virus, which so far has killed 17 people and infected more than 570 And while Beijing’s response has improved in some ways, it has regressed in others It is censoring criticism It is detaining people for spreading what it calls “rumors.” It is suppressing information it deems alarming Though China’s censors are busily scrubbing the Chinese internet, the country’s online community is registering its disappointment and alarm over Beijing’s handling of the new virus that has spread since December from the city of Wuhan to other countries, even the United States.“I thought SARS would force China to rethink its governance model,” Mr Xu, now a video talk show host, wrote on social media on Tuesday, also posting a screenshot of his 2003 quote in The Times “I was too nạve.” In many ways, China has changed for the better since the SARS epidemic Its economy has grown eightfold It has built more skyscrapers, subways and high-speed rail lines than any other country Its tech companies rival Silicon Valley’s giants A more responsive bureaucracy provides more people with health care, social services and even quality-of-life improvements like parks When it comes to handling diseases, the public health system has greatly improved Wuhan, the epicenter of the outbreak, is also home to one of the most advanced epidemic

disease research laboratories in the world Those improvements have come at a price The government has tightened its grip on the internet, the media and civil society It has deeper pockets and a greater ability to control the flow of information across the country As a result, many of the media outlets, advocacy groups, activists and others who held the government accountable in

2003 have been silenced or sidelined “The system is successful in that it destroyed the people with integrity, the institutions with credibility and a society capable of narrating its own stories,” Mr Xu said on social media “What’s left is an arrogant power, a bunch of messy information and many fragile, isolated and angry individuals.”Even as the new virus spread through Wuhan, the government took pains to keep up appearances The first case was reported Dec 8 As the disease spread, Wuhan officials insisted that it was controlled and treatable The police questioned eight people who posted

on social media about the virus, saying they had spread “rumors.”On Saturday, two days before Wuhan told the world about the severity of the outbreak, it hosted apotluck banquet attended by more than 40,000 families so the city could apply for a world record for most dishes served at an event On the day it broke the news to the world, it also announced that it was distributing 200,000 free tickets

to residents for festival activities during the Lunar New Year holiday, which begins this Saturday.The central government backed Wuhan’s officials Wang Guangfa, a prominent government respiratory expert, told the state broadcaster China Central Television on Jan 10 that the Wuhan pneumonia was “under control” and mostly a “mild condition.” Eleven days later, he confirmed to Chinese media that he might have contracted the virus himself during an inspection in Wuhan.Recognizing an outbreak can take time, and China is not the first government caught flat footed by a disease But the choices made by government officials had an impact on a major commercial and transportation hub Wuhan is a city of 11 million people, including nearly one million college students from across the country By the time it disclosed the seriousness of the outbreak, the 40-day Lunar New Year travel season, when Chinese people take an estimated three billion trips combined, had already begun People might have made different decisions had websites and headlines described growing worries Instead, they traveled On Tuesday, all five confirmed cases in Beijing were people who had traveled to Wuhan in January for business, study or leisure Until a week ago, some people

in China called it the “patriotic virus." Cases appeared in Hong Kong, Thailand, Vietnam, Japan and elsewhere in Asia No other Chinese city but Wuhan reported infection cases It was not until the Hong Kong news media reported over the weekend that the virus had been found in other cities did officials elsewhere come forward Some critics see parallels to SARS In 2003, the Guangzhou newspaper Southern Metropolis Daily first reported the SARS outbreak A military doctor, Jiang Yanyong, came forward with what he knew Only then did officials act.“The way this virus came into

the public view is the same as that of SARS 17 years ago,” said Rose Luqiu, an assistant journalism professor who covered SARS as a reporter for the Hong Kong-based Phoenix Television Many of those brave voices in 2003 are gone Like almost all Chinese media outlets that were active in the 1990s and 2000s, the Southern Metropolis Daily has lost its freedom to pursue coverage that holds local governments, if not Beijing, accountable Only a few mainland news media outlets are coveringthe current crisis critically, and then only with an analytical tone In 2003, Phoenix Television called

Ms Luqiu, then a star reporter, back from Iraq to report on SARS in Beijing She shadowed the newly appointed Beijing mayor, Wang Qishan, for a week to cover how the government dealt with the crisis Mr Wang later became the vice president of China That kind of openness is unimaginable now Last week, when a group of Hong Kong journalists went to the Wuhan hospital that took in most corona virus patients, the police detained them for a few hours They were asked to delete their

TV footage and hand in their phones and cameras for inspection On Tuesday, Ms Luqiu wrote an article for qq.com, the news site owned by the internet giant Tencent, about the measures the Hong Kong government has taken in dealing with the virus The article was deleted 10 hours later Dr Jiang, the military doctor who became a whistle-blower in 2003, has been put under periodic house arrest and forbidden to visit the United States to collect a human rights award He is also portrayed as

a bad role model A multiple-choice question posed by a test-prep school in 2017 asked about Dr Jiang’s decision The correct answer was B: It was wrong because it harmed the interests of the nation, the society and the community and should be subject to legal punishment China’s disclosures have improved in many ways since SARS The government admitted the problem faster Beijing officials have shown determination to be more transparent A top party committee said on Tuesday that it would not tolerate any efforts to hide infections.“Whoever deliberately delays or conceals reporting for the sake of their own interests will be forever nailed to history’s pillar of shame,” the committee said in a post on We Chat The post was later deleted But when the government is the only source of information, wise advice and valuable clues can be lost A police bureau in eastern Shandong Province posted on the Twitter-like social media platform Weibo on Wednesday that it had detained four residents who spread rumors that there was a suspected corona virus patient in the district In that environment, others dare not speak out.“The authorities are sending a signal, which is that only the government agencies can talk about the epidemic,” Yu Ping, a former Southern Metropolis Daily reporter, wrote on his personal blog “All other people should just shut up.”“It’s not

monopoly.”(https://www.nytimes.com/2020/01/22/health/virus-corona.html)

C Sheikh eat al told that the scale of an outbreak depends on how quickly and easily a virus is

transmitted from person to person While research has just begun, scientists have estimated that each person with the new corona virus could infect somewhere between 1.5 and 3.5 people without effective containment measures That would make the virus roughly as contagious as SARS, another corona virus that circulated in China in 2003 and was contained after it sickened 8,098 people and killed 774 Respiratory viruses like these can travel through the air, enveloped in tiny droplets that are produced when a sick person breathes, talks, coughs or sneezes These droplets fall to the ground within a few feet That makes the virus harder to get than pathogens like measles, chickenpox and tuberculosis, which can travel a hundred feet through the air But it is easier to catch than H.I.V or hepatitis, which spread only through direct contact with the bodily fluids of an infected person

Corona viruses like the Wuhan virus can travel only about six feet from the infected person It’s unknown how long they live on surfaces Some other viruses, like measles, can travel upto 100 feet

and stay alive on surfaces for hours If each person infected with the new corona virus infects two to three others, that may be enough to sustain and accelerate an outbreak, if nothing is done to reduce it Here’s how that works In the animation below, a group of five infected people could spread the virus

to about 368 people over just five cycles of infection Compare that with a less contagious virus, like the seasonal flu People with the flu tend to infect 1.3 other individuals, on average The difference may seem small, but the result is a striking contrast: Only about 45 people might be infected in the same scenario But the transmission numbers of any disease aren’t set in stone They can be reduced

by effective public health measures, such as isolating sick people and tracking individuals they’ve had contact with When global health authorities methodically tracked and isolated people infected with SARS in 2003, they were able to bring the average number each sick person infected down to 0.4, enough to stop the outbreak Health authorities around the world are expending enormouseffort trying to repeat that So far, the number of cases outside China has been small But in recent days, cases have turned up in several countries, including the United States, with people who have not visited China And the number of cases within China has accelerated, far surpassing the rate of new SARS cases in 2003 This is one of the most important factors in how damaging the outbreak will be, and one of the least understood It’s tough to assess the lethality of a new virus The worst cases are usually detected first, which can skew our understanding of how likely patients are to die About a third of the first 41 patients reported in Wuhan had to be treated in an I.C.U., many with symptoms of fever, severe cough, shortness of breath and pneumonia But people with mild cases may never visit a doctor So there may be more cases than we know, and the death rate may be lower than we initially thought At the same time, deaths from the virus may be underreported The Chinese

cities at the center of the outbreak face a shortage of testing kits and hospital beds, and many sick people have not been able to see a doctor.“There’s still a lot of uncertainty about what this virus is like and what it is doing,” said Dr Allison Mc Geer, an infectious disease specialist at Mount Sinai Hospital in Toronto, who was at the frontlines of the Canadian response to SARS Early indications suggest the fatality rate for this virus is considerably less than another corona virus, MERS, which kills about one in three people who become infected, and SARS, which kills about one in 10 All of the diseases appear to latch on to proteins on the surface of lung cells, but MERS and SARS seem to

be more destructive to lung tissue As of Jan 31, fewer than one in 40 of the people with confirmed infections had died Many of those who died were older men with underlying health problems Here’s how the new corona virus compares with other infectious diseases Pathogens can still be very dangerous even if their fatality rate is low, Dr Mc Geer said For instance, even though influenza has

a case fatality rate below one per 1,000, roughly 200,000 people end up hospitalized with the virus each year in the United States, and about 35,000 people die The time it takes for symptoms to appear after a person is infected can be vital for prevention and control Known as the incubation period, this time can allow health officials to quarantine or observe people who may have been exposed to the virus But if the incubation period is too long or too short, these measures may be difficult to implement Some illnesses, like influenza, have a short incubation period of two or three days People may be shedding infectious virus particles before they exhibit flu symptoms, making it almost impossible to identify and isolate people who have the virus SARS, however, had an incubation period of about five days In addition, it took four or five days after symptoms started before sick people could transmit the virus That gave officials time to stop the virus and effectively contain the outbreak, Dr McGeer said Officials at the Centers for Disease Control and Prevention estimate that the new corona virus has an incubation period of 2 to 14 days But it is still not clear whether a person can spread the virus before symptoms develop, or whether the severity of the illness affects how easily a patient can spread the virus.“That concerns me because it means the infection could elude detection,” said Dr Mark Denison, an infectious disease expert at Vanderbilt University in Nashville, Tenn Wuhan is a difficult place to contain an outbreak It has 11 million people, more than New York City On an average day, 3,500 passengers take direct flights from Wuhan to cities in other countries These cities were among the first to report cases of the virus outside China Wuhan is also a major transportation hub within China, linked to Beijing, Shanghai and other major cities by high-speed railways and domestic airlines In October and November of last year, close to two million people flew from Wuhan to other places within China China was not nearly as well-connected in 2003 during the SARS outbreak Large numbers of migrant workers now travel

domestically and internationally — to Africa, other parts of Asia and Latin America, where China is making an enormous infrastructure push with its Belt and Road Initiative This travel creates a high risk for outbreaks in countries with health systems that are not equipped to handle them, like Zimbabwe, which is facing a worsening hunger and economic crisis Over all, China has about four times as many train and air passengers as it did during the SARS outbreak China has taken the unprecedented step of imposing travel restrictions on tens of millions of people living in Wuhan and nearby cities But experts warned that the lockdown may have come too late and limited access to food and medicine Wuhan’s mayor acknowledged that five million people had left the city before the restrictions began, in the run-up to the Lunar New Year.“You can’t board up a germ A novel infection will spread,” said Lawrence O Gostin, a law professor at Georgetown University and director of the World Health Organization Collaborating Center on National and Global Health Law

“It will get out; it always does.” In addition to closing off transportation, officials shut down a market

in Wuhan selling live poultry, seafood and wild animals, which was thought to be the origin of the corona virus, and later suspended the trade of wild animals nationwide Schools have been closed, Beijing’s Great Wall is off limits and tourist packages from China have been halted World Health Organization officials have praised China’s aggressive response to the virus But the measures have also had unintended effects Residents in Wuhan who are unwell must walk or cycle for miles to get

to hospitals There, many complain that they are being turned away because of shortages of hospital beds, staff and supplies that have been made worse by the lockdown Until recently, researchers abroad were also concerned by the fact that China was not admitting experts who could help track the virus and prevent its spread On Thursday, the W.H.O declared the outbreak a global healthemergency, acknowledging that the disease represents a risk beyond China The United States and Australia are temporarily denying entry to noncitizens who recently traveled to China, and several major airlines said they expect to halt direct service to mainland China for months Other countries —including Kazakhstan, Russia and Vietnam — have temporarily restricted travel and visas But critics fear that these measures will not be enough A corona virus vaccine could prevent infections and stop the spread of the disease But vaccines take time After the SARS outbreak in 2003, it took researchers about 20 months to get a vaccine ready for human trials (The vaccine was never needed, because the disease was eventually contained.) By the Zika outbreak in 2015, researchers had brought the vaccine development timeline down to six months Now, they hope that work from past outbreaks will help cut the timeline even further Researchers have already studied the genome of the newcorona virus and found the proteins that are crucial for infection Scientists from the National Institutes of Health, in Australia and at least three companies are working on vaccine candidates.“If

we don’t run into any unforeseen obstacles, we’ll be able to get a Phase 1 trial going within the next three months,” said Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases Dr Fauci cautioned that it could still take months, and even years, after initial trials to conduct extensive testing that can prove a vaccine is safe and effective In the best case, a vaccine

(https://www.nytimes.com/interactive/2020/world/asia/china-coronavirus-contain.html#transmission)

D A World Health Organization (WHO) senior leadership team, led by Director General Dr Tedros

Adhanom Ghebreyesus, today met President Xi Jinping of the People’s Republic of China in Beijing They shared the latest information on the outbreak and reiterated their commitment to bring it under control The discussions focused on continued collaboration to improve containment measures in Wuhan, to strengthen public health measures in other cities and provinces, to conduct further studies and transmissibility of the virus, to continue to share data, and for China to share biological material with WHO These measures will advance scientific understanding of the virus and contribute to the development such as vaccines and treatments https://www.who.int/news-room/detail/28-01-2020-who-china-leadersdiscuss-next-steps-in-battle-against-coronavirus-outbreak WHO is launching a Global 2019-nCoV Clinical Data Platform to allow Member States to contribute anonymized clinical data in order to inform the public health clinical response WHO is continually monitoring developments and the Director-General can reconvene the Emergency Committee on very short notice as needed Committee members are regularly informed of developments SITUATION IN NUMBERS Globally are 4593 confirmed China total case number confirmed is 4537 and 6973 are suspected while 976 severe and 106 deaths, Outside of China 56 confirmed 14 countries were encircle in involved in this game Similarly Japan 6, Republic of Korea 4, Viet Nam 2 ,Singapore 7 Australia 5, Malaysia 4, Cambodia 1, Thailand 14, Nepal 1, Sri Lanka 1, United States of America 5 ,Canada 2, France 3, Germany 1 Limit human-to-human transmission including reducing secondary infections among close contacts and health care workers, preventing transmission amplification events, and preventing further international spread from China; Identify, isolate and care for patients early, including providing optimized care for infected patients; Identify and reduce transmission from the animal source; Address crucial unknowns regarding clinical severity, extent of transmission and infection, treatment options, and accelerate the development of diagnostics, therapeutics and vaccines; Communicate critical risk and event information to all communities and counter misinformation; Minimize social and economic impact through multisectoral partnerships This can

be achieved through a combination of public health measures, such as rapid identification, diagnosis and management of the cases, identification and follow up of the contacts, infection prevention and

control in healthcare settings, implementation of health measures for travelers, awareness- raising in the population and risk communication WHO has been in regular and direct contact with Member States where cases have been reported WHO is also informing other countries about the situation and providing support as requested WHO has developed interim guidance for laboratory diagnosis, clinical management, infection prevention and control in health care settings, home care for patients with suspected novel corona virus, risk communication and community engagement WHO has provided recommendations to reduce risk of transmission from animals to humans WHO has published an updated advice for international traffic in relation to the outbreak of the novel coronavirus 2019-nCoV Activation of R&D blueprint to accelerate diagnostics, vaccines, and therapeutics WHO has developed an online course to provide general introduction to emerging respiratory viruses, including novel corona viruses WHO is providing guidance on early investigations, which are critical to carry out early in an outbreak of a new virus The data collected from the study protocols can be used to refine recommendations for surveillance and case definitions, to characterize the key epidemiological transmission features of 2019-nCoV, help understand spread, severity, spectrum of disease, impact on the community and to inform operational models for implementation of countermeasures such as case isolation, contact tracing and isolation The first protocol that is available is a: Household transmission investigation protocol for 2019-novel corona virus (2019-nCoV) infection WHO is working with its networks of researchers and other experts to coordinate global work on surveillance, epidemiology, modeling, diagnostics, clinical care and treatment, and other ways to identify, manage the disease and limit onward transmission WHO has issued interim guidance for countries, updated to take into account the current situation WHO is working with global expert networks and partnerships for laboratory, infection prevention and control, clinical management and mathematical modeling During previous outbreaks due to other corona virus (Middle-East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS), human-to-human transmission occurred through droplets, contact and fomites, suggesting that the transmission mode of the 2019-nCoV can be similar The basic principles to reduce the general risk

of transmission of acute respiratory infections include the following: Avoiding close contact with people suffering from acute respiratory infections Frequent hand-washing, especially after direct contact with ill people or their environment Avoiding unprotected contact with farm or wild animals People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands) Within healthcare facilities, enhance standard infection prevention and control practices in hospitals, especially in emergency departments WHO does not recommend any specific health measures for

travelers In case of symptoms suggestive of respiratory illness either during or after travel, travelersare encouraged to seek medical attention and share their travel history with their healthcare provider Travel guidance was updated on 24 January https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200128-sitrep-8-ncov-cleared.pdf

E Westman (Jan 30, 2020) reported that public health experts around the globe are scrambling to

understand, track, and contain a new virus that appeared in Wuhan, China at the start of December.

You can see where and how many cases have been reported in this map created by US researchers

So far, there have been nearly 15,000 confirmed cases and 305 deaths Over 300 people have recovered from the illness The majority of the illnesses are in China, but cases have been reported in nearly two dozen other countries, including the US No deaths related to the illness have been

reported outside of China As this important story continues to unfold, The Verge will update this

page with all the latest news and analysis Our hope to answer all your questions as people work to understand this virus and contain its spread At the end of December, public health officials from China informed the World Health Organization that they had a problem: an unknown, new virus was causing pneumonia-like illness in the city of Wuhan They quickly determined that it was a coronavirus, and that it was rapidly spreading through and outside of Wuhan Corona viruses are common in animals of all kinds, and sometimes can evolve into forms that can infect humans Since the start of the century, two other corona viruses have jumped to humans, causing the SARS outbreak in 2002 and the MERS outbreak in 2012.Scientists think this new virus first became capable of jumping to humans at the beginning of December It originally seemed like the virus first infected people at a seafood market in Wuhan and spread from there But one analysis of early cases of the illness, published January 24th, found that the first patient to get sick did not have any contact with the market Experts are still trying to trace the outbreak back to its source The type of animal the virus originated from is not clear One team of researchers in China published a report arguing that it came from snakes, based on the genetic code of the virus However, scientists are very skeptical of that conclusion Another analysis found that the genetic sequence of the new virus is 96 percent identical

to one corona virus found in bats Both SARS and MERS originated in bats The new virus isn’t SARS, although that also began in China Because it comes from the same viral family as SARS, it has some similarities, but it’s an entirely new virus However, the commonalities mean scientists and public health officials can use what they’ve learned from the past outbreak to try to stop this one.During the SARS outbreak, Chinese officials attempted to conceal cases from WHO inspectors and limit information, both internally and externally This time, officials quickly reported the outbreak of the new virus to the WHO, which praised their quick response and transparency in a press

conference China is also allowing a team of WHO experts to assist Chinese public health officials with the ongoing work, the organization announced January 28th.The US Department of Health and Human Services also said China has been more transparent than they were with SARS “The Chinese government’s level of cooperation is completely different from what we experienced in 2003,” said department Secretary Alex Azar during a press conference But critics and Chinese citizens are skeptical: there are concerns that Chinese officials are undercounting the number of illnesses and are classifying deaths that might have been from the virus as being from pneumonia Wuhan police also investigated citizens for spreading what it called rumors online a few weeks ago.(It’s important

to note that China isn’t the only country known for concealing the extent of public health problems

In the US, for example, dozens of cities have concealed the amount of lead in their public water supply.) It takes information about both how severe an illness is and how easily it can spread to determine how “bad” it can be Epidemiologists often use this tool to assess new flus, for example, and guide decision-making: If an illness isn’t very severe (and kills only a small percentage of people), but it’s highly transmissible, it can still cause devastating effects — if something affects millions, the small percentage it kills will still be a high number of fatalities Researchers are still trying to understand the symptoms of the corona virus, which have ranged from mild, like those in a cold, to severe Around 20 percent of confirmed cases have been severe, according to the WHO That’s 20 percent of the cases that we know about — it’s still possible that there are many more mild cases of the illness that haven’t been flagged, which would shrink the percentage of cases that are severe So far, the fatality rate for the new corona virus is around 2 to 3 percent, though that could continue to change as the outbreak progresses The fatality rate for SARS was about 14 to 15 percent Most deaths in this outbreak have been in older people who have underlying health issues, like heart disease, hypertension, and diabetes (That’s the same demographic who is most at risk of dying from illnesses like the flu.) We don’t yet know how rapidly or easily the virus can spread In China, sick people have been infecting others through person-to-person transmission since the start of January, and the WHO has reported that there have been sustained chains of people passing the virus along for at least four generations: one person got sick (probably from an animal), passed the virus to another person, who passed it to another person People in four countries outside of China —the US, Germany, Japan, Vietnam — were infected with the corona virus by other people, and not from direct travel to China Early evidence suggested that, like other corona viruses, the virus jumps between people who are in very close contact with each other, and probably spreads when an infected person sneezes or coughs But Chinese officials have said that they have seen cases where people

with the virus infected others before they start showing symptoms A letter to The New England

Journal of Medicine also details a case where people who didn’t feel sick appeared to infect others in

Germany If that’s happening regularly, containing the spread of the virus will be more complicated There’s still only limited evidence that asymptomatic people can spread the virus, though And even

if it was happening, it probably wouldn’t significantly affect the outbreak, said Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, in a press conference “Even if there is some asymptomatic transmission, in all the history of respiratory borne illness, asymptomatic transmission has never been the driver of outbreaks,” he said “An epidemic is not driven by asymptomatic carriers.”The WHO says that researchers think each sick person will go on to infect, on average, between 1.4 and 2.5 additional people, though that’s only a preliminary estimate Other teams of researchers have published their own estimates, with most saying a sick person will infect an average of around two or three people Those numbers are called the virus’s R0 (pronounced “R-naught”) The R0 is the mathematical representation of how well an infection might be able to spread The higher the number, the more potentially spreadable it can be For comparison, the R0 for SARS was between two and five But that doesn’t mean each sick person will actually infect that many people; quarantines and other actions taken to control outbreaks of a virus can bring down the number of people a sick person infects If you haven’t recently been to Wuhan, China, or been in close contact with someone who is sick and has recently been to Wuhan, China, it’s very unlikely you have this virus It’s totally normal to feel anxious, though — and there are ways to reduce that anxiety, like by distracting yourself with other activities, or keeping the risks in perspective.If you live in the US, it’s far more likely that you have the flu or the common cold It’s still flu season, and high levels of flu activity aren’t expected to die down anytime soon (It’s not too late to get a flu shot!) If you’re feeling sick and have been to Wuhan, China, or been in close contact with someone who has, tell your doctor about your symptoms Based on what we know so far, you can protect yourself with the same measures you’d take (and should be taking) to protect yourself against the flu: wash your hands, cover your mouth when you cough, and stay away from people who are sick.The

US State Department raised the travel advisory for China to a level 4, saying Americans shouldn’t travel to China because of the virus Level 4 is the most severe warning issued It applies only to areas with a “greater likelihood of life-threatening risks.” US citizens currently in China should

“consider departing using commercial means,” the alert said On January 22nd, officials in Wuhan shut down all transportation in the city, which is home to over 11 million people They closed buses and subways, and canceled all flights and trains in and out of the city The director general of the WHO applauded the decision, saying that it would help control the outbreak and slow the spread into other countries Fifteen other cities, home to a total of 46 million people, are locked down as

well, The New York Times reported.However, other officials weren’t sure if these quarantines would

be effective: “To my knowledge, trying to contain a city of 11 million people is new to science,”

Gauden Galea, the World Health Organization’s representative in China, told the Associated Press

“It has not been tried before as a public health measure We cannot at this stage say it will or it will not work.”Major cities across the country canceled celebrations for the Lunar New Year, a huge holiday in China Until we know how easily the virus spreads, it’s hard to say how significant of an effect it could have in the United States The CDC says the risk to people in the US is currently low.There have been eight confirmed cases in the US: one in Massachusetts, one in Washington state, two in Chicago, three in California, and one in Arizona Seven had recently traveled to Wuhan One

of the patients in Chicago had not traveled to China and caught the virus from his wife (the other patient in Chicago), who had traveled there So far, there have been 241 people under investigation for the new corona virus in the United States As of January 29th, 114 of those cases had tested negative Testing is still underway for the remaining cases The agency said it expects to have more people under investigation and to see more cases in the US as the outbreak progresses.US Secretary of Health and Human Services Alex Azar declared a public health emergency in response

to the corona virus All flights from China to the US are being diverted to seven airports, and any US citizen who has traveled to China will be asked to self-quarantine for 14 days Any US citizen who has been in the Hubei province (where Wuhan is, and where the virus originated) will be held under a formal quarantine for 14 days In addition, any foreign national who has traveled to China in the past

14 days will not be allowed to enter the US, unless they have immediate family members there, according to a proclamation from President Trump That decision is not supported by the WHO, which said countries should not restrict travel or trade in their response to the virus A number of airlines, including United Airlines, British Airways, and Air Canada, are canceling some or all flights

to and from China United Airlines said their decision to do so was due to a drop in demand for those flights Tech companies like Apple started limiting employee travel to China even before the US State Department and CDC warned people against traveling there South Korea’s LG banned travel to China completely, and both Facebook and Razer told employees who had recently returned from China to work from home Foxconn, the Taiwanese electronics company that has factories in China and makes products for tech companies like Apple, said the virus won’t impact their production But China has officially extended the recent Lunar New Year holiday in an effort to curb the virus’ spread, which could delay normal production schedules In a recent earnings call, Apple says it’s accounted for this uncertainty as it looks ahead to the next quarter

(https://www.theverge.com/2020/1/23/21078457/coronavirus-outbreak-china-wuhan-quarantine-F Callaway (31 JANUARY 2020) reported that with no sign that an outbreak of a new corona

virus is abating, virologists worldwide are itching to get their hands on physical samples of the virus They are drawing up plans to test drugs and vaccines, develop animal models of the infection and investigate questions about the biology of the virus such as how it spreads “The moment we heard about this outbreak, we started to put our feelers out to get access to these isolates,” says Vincent Munster, a virologist at the US National Institute of Allergy and Infectious Diseases in Hamilton, Montana His lab is expecting to receive a sample in the next week from the US Centers for Disease Control and Prevention in Atlanta, Georgia, which has led the response to US cases of the virus The first lab to isolate and study the virus, known provisionally as 2019-nCoV, was at the epicenter of the outbreak: in Wuhan, China A team at the Wuhan Institute of Virology led by virologist Zheng-Li Shi isolated the virus from a 49-year-old woman, who developed symptoms on 23 December 2019 before becoming critically ill Shi’s team found1 that the virus can kill cultured human cells and that it enters them through the same molecular receptor as another corona virus: the one that causes SARS (severe acute respiratory syndrome).A lab in Australia announced on 28 January that it had obtained virus samples from an infected person who had returned from China The team was preparing to share the samples with other scientists Labs in France, Germany and Hong Kong are also isolating and preparing to share virus samples they obtained from local patients, says Bart Haagmans, a virologist at Erasmus Medical Center in Rotterdam, the Netherlands “Probably next week we will get isolates from one of the different labs,” he says The first genome sequence of the virus was made public in early January, and several dozen — taken from various people — are now available The sequences have already led to diagnostic tests for the virus, as well as efforts to study the pathogen’s spread and evolution But scientists say that sequences are no substitute for virus samples, which are needed to test drugs and vaccines, and to study the virus in depth “It is essential that viruses are shared,” said Maria Van Kerkhove, an infectious-disease epidemiologist at the World Health Organization in Geneva, Switzerland, in a 29 January press conference Munster says that his lab’s first priority will be to identify animals that experience the infection in a similar way to humans Such animal models will be useful for testing vaccines and drugs The team first plans to look at a mouse genetically engineered to contain a human version of the receptor that SARS virus and the new corona virus uses to infect cells Future work could involve exposing mice and, later, non-human primates to the virus and testing whether vaccines can prevent infection, he adds Munster’s lab is also eager to start gauging how long the virus can survive in the air or in saliva droplets This could