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Coronavirus outbreak explained: An American dies in China

  Artist & # 39; s rendering of a man wearing a surgical mask.

Robert Rodriguez / CNET

China has been fighting for more than a month against an outbreak of pneumonia-like disease, first discovered in the central city of Wuhan in December 201

9. The wave of diseases is caused by a new coronavirus, called 2019-nCoV, that has now infected around 35,000 people and has claimed more than 720 lives.

The disease was first reported to the World Health Organization on New Year's Eve and in the intervening month was linked to a family of viruses known as "coronaviruses, " the same family responsible for SARS and the Middle East respiratory syndrome, as well as some cases of colds.

There are no approved treatments for coronaviruses, but on February 6, China began to enroll a small number of patients in a clinical trial with remdesivir, an experimental antiviral drug made by US pharmaceutical company Gilead that has not yet been approved for use, but has been promising in laboratory studies. "Although there is currently no antiviral data for remdesivir showing activity against 2019-nCoV, the data available in other coronaviruses gives us hope," Gilead said in a statement.

A special WHO committee declared an public health emergency of international importance on January 30, citing "the potential for the virus to spread to countries with weaker health systems." Human-to-human transfer has been confirmed outside of China, including in the US, leading authorities around the world are starting to limit travel and enforce quarantine to protect themselves against the spread.

On February 4, two notable phone manufacturers announced that they would change their plans for Barcelona & # 39; s Mobile World Congress, & # 39; the world's largest mobile trade show, starting on February 24. LG will withdraw from exhibiting and participating, while the Chinese company ZTE has scheduled a press conference for the show. More companies then changed their MWC plans. Phone giant Samsung takes back its presence and Ericsson and Nvidia will not be present.

On February 5, Chinese state media reported that a newborn was diagnosed 2019-nCoV just 30 hours after birth, opening the potential for mother-to-child transmission. Viruses can be transmitted through the placenta, but experts say it's too early to say if this is the case with the new corona virus, which & # 39; unlikely & # 39; is passed on in the womb.

On February 7, Li Li Wenliang, the 34-year-old Chinese doctor who talked about the rising cases of pneumonia in an online chat room during the first days of the outbreak, died from a 2019-nCoV infection. And February 8 saw the announcement of the first known American death from the disease, in which an American citizen died in Wuhan. Observers said that death could increase diplomatic tensions over the Chinese approach to the epidemic, the New York Times reported.

The situation is evolving rapidly. We have collected everything we know about the new virus, what the future offers researchers and some steps you can take to reduce your risk.

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What is a corona virus?

Coronaviruses belong to a family known as Coronaviridae, and under an electron microscope they look like pointed rings. They are named after these spikes, which form a halo or "crown" around their viral envelope.

Coronaviruses contain a single RNA strand in the envelope and cannot propagate as a virus without entering living cells and hijacking their machines. The spikes on the viral envelope help coronaviruses bind to cells, giving them a way to come in, like opening the door with C4. Once inside, they turn the cell into a virus factory, using the molecular conveyor to produce more viruses, which are then sent from the cell. The virus progeny infects other cells and the cycle starts again. Typically, these types of viruses are found in animals ranging from cattle and pets to animals in the wild, such as bats. Some are responsible for diseases such as the common cold. When they make the leap to humans, they can cause fever, respiratory diseases and inflammation in the lungs. In people who are immunocompromised, such as the elderly or people with HIV / AIDS, such viruses can cause serious respiratory diseases, leading to pneumonia and even death.

Extremely pathogenic coronaviruses were behind SARS (severe acute respiratory syndrome) and MERS (Middle Eastern respiratory syndrome) outbreaks in the last two decades. These viruses were easily transmitted from person to person. SARS, which emerged in the early 2000s, infected more than 8,000 people and resulted in nearly 800 deaths. MERS, which appeared in early 2010, infected nearly 2,500 people and led to more than 850 deaths.

Where does the virus come from?

The virus appears to have originated in Wuhan, a Chinese city about 650 miles south of Beijing with a population of more than 11 million people. The Huanan Seafood Wholesale Market, which sells fish, as well as a panoply of meat from other animals, including bats, snakes, and pangolins, was involved in the spread in early January.

Prestigious medical journal The Lancet published a comprehensive summary of the clinical characteristics of patients infected with the disease dating back to December 1, 2019. The very first identified patient was not exposed to the market, suggesting that the virus might be somewhere else came from and was transported to the market, where it was able to thrive.

Chinese authorities closed the fish market on January 1.

Markets are involved in the origin and spread of viral diseases in previous epidemics, including SARS and MERS. A large majority of people who have so far confirmed that the new corona virus has come down have been at the Huanan Seafood marketplace in recent weeks. The market seems to be an integral part of the puzzle, but researchers continue to test and investigate the original cause.

An early report, published in the Journal of Medical Virology on January 22, suggested that snakes were the most likely animal reservoir for wildlife before 2019-nCoV, but the work was solidly refuted by two further studies just one day later , on Jan 23.

Getty Images

How do we know that it is a new corona virus?

In short, science!

The Chinese Center for Disease Control and Prevention sent a team of scientists to Wuhan to gather information about the new disease and perform tests on patients, hoping to isolate the virus. Their work, published in the New England Journal of Medicine on January 24, examined samples from three patients. With the help of an electron microscope, which can resolve images of cells and their internal mechanics, and studying the genetic code, the team was able to visualize and genetically identify the new corona virus.

Insight into the genetic code helps researchers in two ways: it allows them to make tests that can identify the virus from patient samples, and it gives them potential insight into making treatments or vaccines.

In addition, the Peter Doherty Institute in Melbourne, Australia, was able to identify the virus and grow it in a laboratory from a patient sample. They announced their discovery on January 28. This is seen as one of the most important breakthroughs in vaccine development and offers laboratories the opportunity to both assess health information and provide expert and detect the virus in patients suspected of having the disease.

How does the corona virus spread?

This is one of the most important questions that researchers are still working hard on. The first infections were possibly due to animal-to-human transmission, but confirmation that human-to-human transmission was obtained at the end of January.

The Center for Infectious Disease Research and Policy at the University of Minnesota reported that health workers in China were infected with the virus at the end of January. This was a remarkable turning point during the SARS epidemic, as health workers moving between countries could help spread the disease.

"The main concern is outbreaks in hospitals, which were observed in SARS and MERS coronaviruses," said C. Raina MacIntyre, a professor of global biosafety at the University of New South Wales. "Careful triage and infection control is needed to prevent these outbreaks and to protect health professionals."

There is some suggestion that the virus can spread before symptoms appear, according to a report from the BBC citing Chinese officials. The incubation period – when the virus accumulates in the body – can last between one to 14 days without a patient realizing that they have been infected. However, it must be emphasized, experts still do not know for sure how contagious this period is.

On February 5, the Chinese state media reported that a newborn was diagnosed with 2019-nCoV only 30 hours after birth, opening the potential for mother-to-child transmission. Viruses can be transmitted through the placenta, but experts say it's too early to say if this is the case with the new corona virus, which & # 39; unlikely & # 39; is passed on in the womb.

How does the world fight spreading?

In Wuhan, the authorities rushed to build a hospital with a thousand beds to treat coronavirus patients while the province suffers from hospital bed shortages. It started taking patients on February 4.

China closed Wuhan to reduce the spread of the virus and canceled transport from the city from January 10 to January 23. The travel restrictions were extended to four other cities (Huanggang, Ezhou, Chibi and Zhijiang) later that day, and restrictions were announced in eight cities on January 24 – affecting more than 35 million people.

The restrictions were enforced during a busy travel period for China, when citizens usually travel for the Lunar New Year. Major public events Chinese capital Beijing were canceled and both the Forbidden City of Beijing and Disneyland in Shanghai were closed from January 25. All restrictions and closures will last indefinitely.

The scale of the global efforts to control the disease is immense . Hong Kong closed many public facilities on January 28 and has prevented travel between mainland China. The US has announced major border control measures at 20 ports of entry and has considered canceling flights to and from the epicenter of the Wuhan outbreak. Esports tournaments have been postponed, Shanghai and Hong Kong Disneyland have closed, Olympic women's football tournaments have been completely relocated and McDonald's has closed thousands of locations in China where the virus is spreading.

British Airways on January 29 suspended all flights to and from mainland China "for the next few days," a spokesman confirmed via email. American Airlines and Delta also suspend service to mainland China, although Delta will continue to operate flights until February 5 for customers wishing to leave China. The national airline in Australia, Qantas, announced the suspension of flights from Sydney to Beijing and Sydney to Shanghai from 9 February. The New Zealand airline Air New Zealand suspended daily flights to Shanghai on 1 February.

Cruise ships have also started denying passengers, with Royal Caribbean announcing on February 7 that it will refuse entry to "all holders of China, Hong Kong and Macau passports, regardless of their stay." It also blocks anyone who has traveled to China, Hong Kong or Macau in the 15 days prior to boarding; and anyone who has arrived within six feet of someone from China, Hong Kong or Macau 15 days earlier; and anyone with a fever or low blood oximetry. Norwegian Cruise Line refuses access to anyone who has traveled through China, Hong Kong and Macau within 30 days prior to the cruise, and to anyone who has a passport from those places.

On January 31, the US Secretary of Health and Human Services Alex Azar declared a public health emergency stating the nation's intention to protect and respond to the outbreak while noting that & # 39; the risk for Americans remains low. "Australia and Japan followed. On February 4, the British Foreign Ministry and the French Foreign Ministry warned citizens to evacuate China to lower their risk of infection.

  Coronavirus that causes SARS seen in an electron microscope" data-original = "https://cnet3.cbsistatic.com/img/QYRLDO9YT8kcpzewxctR2eBnZxY=/2020/01/21/144e65f7-60cd-4dc7-ab7c-d93fbad6f24/75724-759 gettyimages-1134490146.jpg Ca caused the corruption of Son in an electron microscope

An electron microscope image of the corona virus that causes SARS.

Getty Images

How contagious is the corona virus?

A widely shared Twitter thread by Eric Feigl-Ding an epidemiologist from Harvard University, suggests that the new coronavirus & # 39; thermonuclear pandemic level is poor & # 39; is known as the "r nothing" (R0) value based on a metric. This statistic helps determine the basic reproduction number of an infectious disease. In the simplest terms, the value refers to how many people can be infected by one person who carries the disease. It was widely criticized before it was removed.

Infectious diseases such as measles have an R0 of 12 to 18, which is remarkably high. The 2002-2003 SARS epidemic had an R0 of about 3. A handful of studies that model the 2019-nCoV outbreak have given a comparable value with a range between 1.4 and 3.8. However, there is a wide variation between studies and models that try to predict the R0 of new coronavirus due to the constantly changing number of cases.

In the early stages of understanding the disease and its spread, it must be emphasized that these studies are informative, but they are not definitive. They give an indication of the potential of the disease to go from person to person, but we still do not have enough information about how the new virus is spreading.

"Some experts say this is the most contagious virus ever – that's wrong," MacIntyre said. "If it was highly contagious (more contagious than flu as some suggest), we should have seen hundreds if not thousands of cases outside of China, since Wuhan is an important travel center."

China has suggested that the virus can spread before symptoms are present. MacIntyre wrote in The Conversation on January 28 that there has been no evidence for these claims so far, but it does suggest that children and adolescents can be contagious without showing symptoms. This also makes screening at airports less impactful, because the disease has the port but shows no signs, so that it can be treacherously spread further.

Do you have to worry?

As the virus continues to spread, it is easy to get caught in the fear and alarm that escalates via social media. There is misinformation and disinformation about the effects of the disease where it spreads and how. Experts still warn that the virus appears to be mild, especially when compared to infections by other viruses, such as flu or measles.

CNET has established a fact-finding check on some rumors and myths that have spread.

WHO Declares a Public Health Emergency Situation

On January 30, the World Health Organization declared a public health emergency of international concern over the corona virus outbreak. Tedros Adhanom Ghebreyesus, the Director General of the WHO, said the organization is working with national and international public health partners to get the outbreak under control.

The WHO has also made recommendations to prevent the spread of the virus and to ensure a "measured and fact-based response".

In the fall, an emergency committee met on the Ebola virus epidemic in the Democratic Republic of Congo. The meeting outlined the key strategies and commitments to strengthen and protect the spread of the disease.

On Thursday, search giant Google announced that they would collaborate with the WHO and help disseminate information through their results page.

What are the symptoms?

The new coronavirus causes symptoms that are similar to those of previously identified pathogenic coronaviruses. In currently identified patients, there appears to be a spectrum of diseases: a large number experience mild pneumonia-like symptoms, while others have a much more serious reaction.

On January 24, the prestigious medical journal The Lancet published an extensive analysis of the clinical features of the disease.

According to the report, patients with:

  • present fever, elevated body temperature.
  • Dry cough.
  • Fatigue or muscle pain.
  • Breathing difficulties.

Less common symptoms of coronavirus include:

  • Coughing up mucus or blood.
  • Headache. Diarrhea.

As the disease progresses, patients also develop pneumonia, causing the inflammation. lungs and ensures that they fill with fluid. This can be detected with an X-ray and was present in all 41 cases examined.

Is there a treatment for coronavirus?

Coronaviruses are hardy organisms. They are effective in hiding the human immune system and we have not developed reliable treatments or vaccines to eradicate them. In most cases, health officials try to deal with the symptoms.

"There is no recognized therapeutic agent for coronaviruses," said Mike Ryan, executive director of the WHO Health Emeridents Program, during the press conference of the Emergency Committee on January 29. "The primary goal of a coronavirus outbreak is to provide patients with adequate care, particularly in the field of respiratory support and multi-organ support."

However, that does not mean that vaccines are impossible. Chinese scientists were able to sequence the virus's genetic code incredibly quickly, giving scientists the chance to study it and look for ways to combat the disease. According to CNN, researchers from the US National Institutes of Health are already working on a vaccine although it may be a year or more away from release.

SARS in particular, which infected around 8,000 people and killed around 800, appeared to have its course and then largely disappeared. It was not a vaccine that changed the tide, but effective communication between countries and a series of tools that helped to monitor the disease and its spread.

"We have learned that epidemics can be controlled without drugs or vaccines, using improved surveillance, case isolation, contact tracking, PPE and infection control measures," MacIntyre said.

A handful of organizations and research institutes have started working on vaccines, according to Global Times.

In addition, China is conducting clinical trials with the experimental antiviral drug remdesivir, originally developed to treat Ebola. Remdesivir was also given to an American patient in the state of Washington whose symptoms worsened. In that case, doctors made a & # 39; compassionate use & # 39; request to the Food and Drug Administration. This allows people to try experimental drugs outside of clinical trials, usually in emergency situations.

China is also conducting a small clinical study of Kaletra, an anti-HIV drug, according to The Guardian.

Developing new drugs requires time and resources, so "while waiting for the new panacea, it is worth looking for existing drugs that can be reused" to treat new viruses, Stephen Morse, a professor at Columbia University & # 39; s Mailman School of Public Health, told Live Science.

How to reduce the risk of coronavirus

With confirmed cases now seen around the world , it is possible that 2019-nCoV will spread much further than China. The WHO recommends a series of measures to protect yourself against the disease, based on good hand hygiene and good respiratory hygiene – in the same way that you would reduce the risk of influenza . The new coronavirus spreads and infects people slightly differently than the flu, but because it primarily affects the respiratory tract, the protection measures are quite similar .

Meanwhile, the US Department of Foreign Affairs issued a travel advisory on January 30 with a blunt message: "Do not travel to China." Een eerdere waarschuwing van de CDC adviseerde mensen om "niet-essentiële reizen te vermijden."

Een Twitter-thread, ontwikkeld door de WHO, staat hieronder.

U kunt ook overwegen een gezichtsmasker te kopen om uzelf te beschermen tegen het virus. U bent niet de enige – voorraden gezichtsmaskers zijn over de hele wereld uitverkocht, waarbij Amazon en Walmart.com tekorten hebben. Ik meldde me deze week vanuit Sydney en zag rijen bij de apotheek die zich in de straat uitstrekten.

Het risico om het virus buiten China op te lopen, blijft laag, maar als u overweegt een masker te kopen, wilt u precies weten welk gezichtsmasker u zou moeten zoeken. Wegwerpmaskers kunnen grote druppels beschermen tegen het binnendringen van de mond of neus, maar een masker is veel effectiever. Het wellness-team van CNET heeft een uitgebreide gids samengesteld voor welke maskers u moet kopen .

Oorspronkelijk vorige maand gepubliceerd en regelmatig bijgewerkt met nieuwe ontwikkelingen.

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