Understand how we got here — and how to move forward.


January 27, 2020

Experts warn it might not be possible to contain new coronavirus, as US cases grow

Daily Briefing

    Health officials have confirmed three more cases of the new coronavirus in the United States, as research suggests stopping the virus' spread might be harder than originally thought.

    How the outbreak started

    Reports of the new coronavirus first surfaced in early December 2019 among people in Wuhan, which is the capital of China's Hubei province. According to the World Health Organization (WHO), the main symptoms of infection from the Wuhan coronavirus, called 2019-nCoV, are fever and lesions in both lungs. Some patients also have reported difficulty breathing, WHO said.

    The Chinese outbreak's origin has been connected to a now-closed live seafood market that also sold exotic animals. Researchers who examined the virus' genetic code believe the disease initially infected humans through exposure to snakes sold at the market, and then was spread via human-to-human transmission. The researchers said they still are unsure how the virus adapted to survive in both cold-blooded and warm-blooded hosts.

    Number of cases soars

    Reported cases of the virus have climbed quickly and extended beyond Wuhan. China's National Health Commission on Monday said they have confirmed 2,744 cases of the virus in China alone. Reported cases of the virus involve patients in Australia, China, France, Japan, Korea, South Korea, Thailand, Vietnam, and the United States. They include patients who have not visited Wuhan or had contact with animals.

    A study published Friday in The Lancet found the virus has infected both people with underlying health conditions and healthy people. The researchers, who analyzed data on the first 41 patients with confirmed cases of the infection in Wuhan who were admitted to hospitals, found the majority of infected patients were healthy. They also found two-thirds of them had been to Wuhan's now-closed live seafood market. According to the researchers, nearly 33% of the patients needed intensive care, and six of them died.

    Chinese officials on Monday said there have been 80 reported deaths linked to the virus in the country. China's health commission said the deaths largely occurred among older men, many of whom had underlying health conditions, such as cirrhosis of the liver, diabetes, hypertension, and Parkinson's disease. However, officials said one of the deaths occurred among a 36-year-old man.

    Experts warn it might not be possible to contain the virus

    Ma Xiaowei, head of China's National Health Commission, on Sunday also warned that infected patients who aren't showing symptoms of the virus still could pass the virus onto to others, after a separate study published Friday in The Lancet suggested infected patients without symptoms might be able to spread the virus. That would make the virus different from SARS, which wasn't transmitted before patients began developing symptoms of infection, STAT News reports.

    Instead, the new virus would be more like influenza and measles, which can be transmitted from patients who are infected with the virus but "not yet feeling sick," according to STAT News. The virus' incubation period is between 10 to 14 days, according to Ma.

    Experts said it might be impossible to contain the new virus if it in fact can be transmitted from infected individuals who aren't displaying symptoms.

    Allison McGeer, an infectious disease specialist who has helped countries address outbreaks of SARS and MERS, said, "The more we learn about it, the greater the possibility is that transmission will not be able to be controlled with public health measures."

    Neil Ferguson, an infectious disease expert at Imperial College London who is studying the new coronavirus outbreak, said there already could be tens of thousands of cases of the virus in China that haven't yet been reported or confirmed, "Despite the enormous and admirable efforts in China and around the world, we need to plan for the possibility containment of this epidemic isn't possible," he said.

    Trevor Bedford, a computational biologist at the Fred Hutchinson Cancer Research Center in Seattle, warned that failing to contain the virus quickly could mean the world would be "looking at a pandemic."

    But others noted that the new studies are based on small numbers of patients, and therefore should be viewed and interpreted with caution.

    Nancy Messonnier, director of CDC's National Center for Immunization and Respiratory Diseases, said CDC doesn't "have any clear evidence of patients being infectious before symptom onset," though officials "are actively investigating that possibility."

    Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, also said experts have not yet seen data indicating that asymptomatic individuals could spread the disease. He added, "Mother Nature is throwing us a curveball with this outbreak, but we shouldn't accept every claim like this until we see the data."

    WHO on Thursday said the outbreak constitutes a public health emergency in China, but delayed its decision on whether to classify the outbreak as a global public health emergency, saying it needs more information on the virus. Tedros Adhanom Ghebreyesus, WHO's director general, at the time said, "Make no mistake. This is an emergency in China, but it has not yet become a global health emergency."

    US confirms 3 more cases, but experts say the virus likely won't be widespread in US

    CDC officials on Sunday confirmed three more cases of the coronavirus in the United States, bringing the total number of U.S. cases to five.

    The latest cases—two of which were confirmed in California and one that was confirmed in Arizona—involve three patients who recently travelled to Wuhan.

    Barbara Ferrer, director of the Los Angeles Department of Public Health, said one of the patients was travelling from Wuhan to a different destination but had a layover at Los Angeles International Airport (LAX) . When the traveler arrived at LAX on Jan. 22, wearing a mask, the traveler alerted airport staff about possibly being infected with the virus. The traveler was taken directly to a hospital and has been isolated, minimizing the risk that the traveler might have transmitted the virus to others, officials said.

    Health officials in Orange County identified the second California patient, who also has been isolated at a hospital. The third patient, who was identified in Maricopa County, Arizona, is a member of the Arizona State University community but does not live in university housing, officials said. That patient has been isolated, and officials are working to identify and connect anyone who might have been exposed to the virus.

    In total, federal health officials said more than 100 individuals across 26 states are being monitored for potential infections from the virus because they have travelled to Wuhan or they had contact with infected patients and have experienced symptoms of the virus. Officials said 25 individuals who were being monitored have tested negative for the virus.

    Messonnier said, overall, risk of widespread transmission of the virus in the United States is low, though she expects more cases of infection will be confirmed in the country in coming days. Messonnier said CDC is preparing to send testing kits to state health departments, which will allow state health officials to confirm infections without having to send samples from patients to CDC. However, she said those kits will take a few weeks to get ready.

    Brandon Brown, an epidemiologist at University of California Riverside, said Americans shouldn't "panic" over the virus unless they're "paid to panic." He said, "Public health workers should be on the lookout. The government should be ready to provide resources. Transmitting timely facts to the public is key." However, he added, "[F]or everyone else: Breathe" (New York Times, 1/27; Buckley et al., New York Times, 1/26; Shih et al., Washington Post, 1/25; Joseph, STAT News, 1/24; Branswell, STAT News, 1/26; Findell/Armour, Wall Street Journal, 1/26; Zhou/Horwitz, Reuters, 1/26; Kim, Vox, 1/26; Baumgaertner, Los Angeles Times, 1/24; Wigglesworth et al., Los Angeles Times, 1/26; Moritsugu, Associated Press, 1/27; Owermohle/Cancryn, Politico, 1/24).

    Have a Question?


    Ask our experts a question on any topic in health care by visiting our member portal, AskAdvisory.