New and tougher restrictions on movement and the trade in wild animals are to be imposed in China to try to contain the pneumonia outbreak caused by a new coronavirus, the country’s health commission minister has said, warning that the virus was showing greater potential to pass from one person to another, possibly before symptoms show.
“The transmissibility shows signs of increasing,” said Ma Xiaowei on Sunday, but he added that much was still unknown about the virus.
“For this new coronavirus we have not identified the source of the infection and we are not clear about the risk of its mutation and how it spreads,” he said. “Since this is a new coronavirus there might be some changes in the coming days and weeks, and the danger it poses to people of different ages is also changing.”
The possibility that, unlike Sars, people can pass on the virus before they appear to be ill is very alarming to public health experts. It would make the virus far harder to detect and make it much more difficult to quarantine cases.
On Sunday officials in China also announced the suspension of long-distance buses in the eastern province of Shandong, which has a population of 100 million people. Long-distance buses have also been banned from departing from or arriving at Beijing and Shanghai.
The developments came as:
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The death toll from the outbreak rose to 56, while authorities said almost 2,000 had been infected.
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The mayor of Wuhan said he expected another 1,000 new cases in the city, and revealed that 5 million residents had left the city before it went into lockdown, due both to the virus and the lunar new year festival.
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The US, France and Japan said they were arranging evacuation flights for people trapped in Wuhan, which has been placed under quarantine.
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The UK home secretary, Priti Patel, refused to confirm or deny reports that Britain was planning similar action. So far, 52 people across England, Wales, Scotland and Northern Ireland have been tested for the virus. All have tested negative.
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The US reported a third case, a man in California who had returned from Wuhan. Singapore and South Korea each confirmed a new case, while Thailand said it had identified three new cases.
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The financial hub of Shanghai, which has extensive international air connections, on Sunday reported its first death: that of an 88-year-old man who already had health problems.
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In Hong Kong, protesters torched a building the authorities had designated for quarantine of the families of anybody who becomes ill, demanding that the authorities block the border with mainland China to prevent transmission.
Authorities believe the new strain of coronavirus came from a seafood market in Wuhan, where wildlife was sold illegally. The city remains under a strict lockdown, while various travel restrictions have been imposed across at least 20 other cities, affecting tens of millions of people. China has temporarily banned all live animal markets.
On Sunday evening, Wang Xiaodong, the governor of Hubei province, where most cases have been concentrated, said the party central committee and the people of the whole country were worried. “We felt very sad, very guilty,” he said.
The disease has so far spread to more than 10 other countries, including France, the US and Australia.
There are concerns that screening efforts may not identify all people who carry the disease. An article published in the Lancet, based on a family who had recently visited Wuhan, suggested it was possible to have the virus while not experiencing any symptoms. It is not clear whether patients who are asymptomatic can also transmit the disease.
The incubation period for the virus could range from one day to two weeks, Ma said, but experts remained unclear about the risk of the virus mutating and said it was possible that the number of infections would continue to grow.
On Sunday, Beijing said the reopening of schools and universities after the new year holiday had been indefinitely suspended. Elsewhere, Hong Kong Disneyland announced on Sunday it had closed following the government’s declaration of an emergency to combat the crisis.
Health teams are working urgently to determine the origin of the disease. It is from the same family of viruses as Sars, which was passed to humans from bats by masked palm civets, and Mers, which was carried from bats to humans by camels.
What is the virus causing illness in Wuhan?
It is a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals, or possibly seafood. New and troubling viruses usually originate in animal hosts. Ebola and flu are examples.
What other coronaviruses have there been?
Severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals.
What are the symptoms of the Wuhan coronavirus?
The virus causes pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. If people are admitted to hospital, they may get support for their lungs and other organs as well as fluids. Recovery will depend on the strength of their immune system. Many of those who have died are known to have been already in poor health.
Is the virus being transmitted from one person to another?
In the past week, the number of confirmed infections has more than tripled and cases have been found in 13 provinces, as well as the municipalities Beijing, Shanghai, Chongqing and Tianjin. The virus has also been confirmed outside China, in Hong Kong, Macau, Japan, Nepal, Singapore, South Korea, Taiwan, Thailand, the US, and Vietnam. There have not been any confirmed cases in the UK at present, with the 14 people tested for the virus all proving negative. The actual number to have contracted the virus could be far higher as people with mild symptoms may not have been detected.
How worried are the experts?
There were fears that the coronavirus might spread more widely during the week-long lunar new year holidays, which start on 24 January, when millions of Chinese travel home to celebrate, but the festivities have largely been cancelled and Wuhan and other Chinese cities are in lockdown.
At what point should you go to the doctor if you have a cough, say?
Unless you have recently travelled to China or been in contact with someone infected with the virus, then you should treat any cough or cold symptoms as normal. The NHS advises that there is generally no need to visit a doctor for a cough unless it is persistent or you are having other symptoms such as chest pain, difficulty breathing or you feel very unwell.
Should we panic?
No. The spread of the virus outside China is worrying but not an unexpected development. It increases the likelihood that the World Health Organization will declare the outbreak to be a public health emergency of international concern on Thursday evening. The key concerns are how transmissible this new coronavirus is between people and what proportion become severely ill and end up in hospital.
Sarah Boseley Health editor and Hannah Devlin
The new nationwide ban on the sale of wildlife will affect markets, restaurants and online shops. Health experts have long raised concerns about unhygienic and cramped conditions in some Chinese markets, where wild and often poached animals are packed together.
In Wuhan, where the outbreak began, the streets remained deserted on Sunday, with rules keeping most private cars off the roads. Relatives who would usually have spent the new year holiday together were forced to cancel plans and stay in their separate homes.
Some residents told the Guardian they were remaining calm and believed the quarantine measures were the only way to halt the virus. Others, however, expressed concern about how vulnerable people would be affected by the lockdown.
“Each time the government issues different measures, it is a rough approach, and they are the ones who cause panic. I couldn’t sleep at night when they announced to close the city and I was in shock,” said Miss Huang, 22, from Wuhan, who added that the local government’s failure to act quickly had created distrust.
The increase in reported deaths and illnesses does not necessarily mean the crisis is getting worse, but could reflect better monitoring. Those killed by the virus have mostly been middle-aged or elderly people, as well as people with underlying health conditions.
