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January 21, 2020 seemorerocks Comments 0 Comment

Chinese
Mystery Disease Update No 4: Hundreds of millions of Chinese are on
the move this week as human-to-human transmission confirmed: Will
spread more quickly and widely: No of cases in the 1000s

Photo
David Paulk

Coronavirus
Is Spreading Quickly Across China as Confirmed Cases Triple.
Pneumonia-like
illness is transmittable between humans, reaching major
metropolitan. areas in China.
The
infection spreads to Beijing and Shanghai.
China
confirms new SARS-like virus HAS spread between humans as 14 medics
catch the killer infection after treating patients.
“No
need to panic” the virus was not spreading significantly within
China as (hundreds of millions of Chinese are on the move for New
Year holiday).
Medics
in hazmat suits scanning plane passengers for China’s mysterious
Wuhan virus is stoking fears of a global epidemic

20
January, 2020

It
is the biggest holiday in the world as hundreds of millions of
Chinese are on the move this week to celebrate the Chinese New Year
on Sunday, a tiny per cent of these will be unknowingly carrying the
mysterious coronavirus, which has just been confirmed can be passed
on to humans by humans. The scenario which will follow this is
horrific.

The head of a Chinese government expert team said
Monday that human-to-human transmission has been confirmed in an
outbreak of a new coronavirus, a development that raises the
possibility that it could spread more quickly and widely. Team
leader Zhong Nanshan, a respiratory expert, said two people in
Guangdong province in southern China caught the virus from family
members, state media said. Some medical workers have also tested
positive for the virus, the English-language China Daily newspaper
reported. The late-night announcement capped a day in which
authorities announced a sharp uptick in the number of confirmed
cases to more than 200, and China’s leader called on the
government to take every possible step to combat the outbreak. Now
that is the official version, below is the truth.

Published 4
days ago

The number of
people already infected by the mystery virus emerging in China is
far greater than official figures suggest, scientists have told the
BBC. There have been 45 laboratory-confirmed cases of the new virus,
but UK experts estimate the figure is closer to 1,700. Two people
are known to have died from the virus, which appeared in Wuhan city
in December. “I am substantially more concerned than I was a
week ago,” disease outbreak scientist, Prof Neil Ferguson,
said. The work was conducted by the MRC Centre for Global Infectious
Disease Analysis at Imperial College London, which advises bodies
including the UK government and the World Health Organization.

Below
is the summary from the disease outbreak scientist, Prof Neil
Ferguson:

We
estimate that a total of 1,723 cases of 2019-nCoV in Wuhan City (95%
CI: 427 – 4,471) had onset of symptoms by 12th January 2020 (the
last reported onset date of any case). This estimate is based on the
following assumptions: Wuhan International Airport has a catchment
population of 19 million individuals. There is a mean 10-day delay
between infection and detection, comprising a 5-6 day incubation
period and a 4-5 day delay from symptom onset to
detection/hospitalisation of a case (the cases detected in Thailand
and Japan were hospitalised 3 and 7 days after onset, respectively)
Total volume of international travel from Wuhan over the last two
months has been 3,301 passengers per day. This estimate is derived
from the 3,418 foreign passengers per day in the top 20 country
destinations based on 2018 IATA data, and uses 2016 IATA data held
by Imperial College to correct for the travel surge at Chinese New
Year present in the latter data (which has not happened yet this
year) and for travel to countries outside the top 20 destination
list.

Caveats

We
assume that outbound trip durations are long enough that an
infected Wuhan resident travelling internationally will develop
symptoms and be detected overseas, rather than being detected after
returning to Wuhan. We also do not account for the fact that
international visitors to Wuhan (such as the case who was detected
in Japan) might be expected to have a shorter duration of exposure
and thus a lower infection risk than residents. Accounting
for either factor correctly requires additional data but would
increase our estimate of the total number of cases.
We
estimate the potential number of symptomatic cases with disease
severity of a level requiring hospitalisation (both the cases
detected in Thailand and Japan were moderately severe). Our
estimates do not include cases with mild or no symptoms.
The
incubation period of 2019-nCov is not known and has been
approximated with the estimates obtained for MERS-CoV and SARS
[8,9].
We
assume that international travel is independent of the risk of
exposure to 2019n-CoV or infection status. If zoonotic exposure was
biased towards wealthier people, travel frequency may be correlated
with exposure. Also, some travel might be causally linked to
infection status (to seek healthcare overseas) or the infection
status of contacts in Wuhan (this may apply to the case detected in
Japan) [10]. Accounting for either association would increase
the probability of a case travelling and therefore reduce our
estimates of the total number of cases.

Sensitivity
analysis

We
explore the sensitivity of estimates of total cases to our
assumptions about: i) the duration of the detection window
(exploring a lower value of 8 days); ii) the catchment population
size of Wuhan airport (assuming it might be 11 million, the
population of Wuhan city, rather than 19 million, the population of
the entire metropolitan area); and iii) true exportations reported
internationally (2, 3 and 4 cases). Table 1 summarises the baseline
assumptions and alternative scenarios explored. We note that the
currently reported number of cases (44) is substantially lower than
the lower bound of our most conservative scenario (190 cases,
Scenario 3).

Conclusions

It
is likely that the Wuhan outbreak of a novel coronavirus has caused
substantially more cases of moderate or severe respiratory illness
than currently reported. The estimates presented here suggest
surveillance should be expanded to include all hospitalised cases of
pneumonia or severe respiratory disease in the Wuhan area and other
well-connected Chinese cities. This analysis does not directly
address transmission routes, but past experience with SARS and
MERS-CoV outbreaks of similar scale suggests currently
self-sustaining human-to-human transmission should not be ruled
out. MRC
Centre for Global Infectious Disease