Coronavirus Epidemic

This report is as of 17:00 GMT on Friday, 21 February 2020.

The world is suffering an epidemic of a newly evolved strain of coronavirus. Covid-19 is the designated name of the disease caused by the virus SARS-CoV-2. The virus itself is so named because it is a newly evolved strain in the same species responsible for SARS (severe acute respiratory syndrome), which caused an outbreak in China in 2002-2003.

The outbreak of Covid-19 began in Wuhan, China in late November 2019.

Latest News:

76,775 confirmed infections have been reported, up by 1000 from yesterday. In the past week, China has 3 times revised the way cases are counted. The New York Times: “Over the past week, the authorities in the province of Hubei, home to the city at the epicenter of the outbreak, Wuhan, have revised their case tallies 3 times because of shifting definitions of what counts as a confirmed case and what officials described as previously unknown information. Chinese officials acknowledged on Friday that their methods of confirming and reporting infection numbers had sown confusion and mistrust. They pledged to share data more openly and efficiently.”

The latest revision resulted in a uptick of cases, as prisoners in Hubei had not been included before. The prison department had not previously been hooked into the epidemic reporting system. Prisons in other provinces have had the same problem, so infected cases in China are poised to leap in the next few days.

2 hospitals in Beijing are reporting a jump in cases, among them numerous medical workers. Italy reported its first cases (6 people) from local transmission Friday – further evidence that the Covid-19 continues to furtively spread.

98% of the confirmed cases have been in mainland China (74,467 cases), with the central Chinese province of Hubei having had 80% of the infections, as well as over 95% of the deaths. At least 2,000 healthcare workers in China have become infected with Covid-19.

There are 1,308 confirmed cases outside mainland China, in 28 countries: South Korea (204 – a jump by 100 since yesterday), Japan (97), Singapore (85), Hong Kong (68), Thailand (35), Taiwan (26), Malaysia (22), Germany (16), Vietnam (16), United States (16), Australia (15),  France (12), Macau (10), Britain (9), Canada (9), United Arab Emirates (9), Iran (13), India (3), Philippines (3), Italy (3), Iran (2), Russia (2), Spain (2), and a single case each in Belgium, Sri Lanka, Nepal, Cambodia, Israel, Egypt, Lebanon, Sweden, and Finland.

South Korea reported today a surge in confirmed infections and a 2nd death. The latest reported outbreak came from a secretive Christian church, whose members account for 2/3rds of the new infections in that country. At the Shincheonji Church of Jesus, members continued to sit packed together on the floor of the church even when sick. Other church members have further spread the disease. The church dismissed criticism of its practices, calling it “slandering based on the prejudices among the established churches.”

Roughly 80% of those with Covid-19 suffer only mild symptoms, with 15% severe and only 3% critical. Unsurprisingly, those in marginal or poor health before becoming infected with Covid-19 are most at risk of succumbing. The death rate from Covid-19 – based upon number infected divided by fatalities – stands at 2.9%. This ratio continues to creep up, but should not be considered a representative sample, as there are likely to be thousands of unreported cases.

Many infected may not realize it because their symptoms are so mild. There have been over 100 cases outside China of person-to-person spread of Covid-19.

18,864 people are reported to have recovered from infection: 1,982 more than yesterday.

The death toll from Covid-19 is now at 2,248: 118 more people than yesterday. Men, the biologically weaker sex, are more likely to die from Covid-19 than women. Though men and women are equally represented in infections, 64% of the reported deaths have been men.

Ukrainian model Anastasiya Zinchenko refused to be evacuated from Wuhan because she was not allowed to take her Pomeranian pup with her. No report yet on whether Ukrainian songwriters are working on a ditty titled “Stand By Your Dog.”

After weeks of restricted travel and mandatory in-home quarantine, China is starting to ease curbs on movement of people and traffic in many areas, as local governments prod factories to restart production. The Chinese government is trying to balance stamping out the epidemic while preventing further economic damage.

The outbreak has rocked commodities markets and disrupted the supply networks that act as the backbone of the global economy. Prices for key industrial raw materials such as copper, iron ore, nickel, aluminum and liquid natural gas have plummeted since the outbreak began.

The global luxury goods sector has taken a huge hit from Covid-19. Chinese buyers had accounted for 40% of the $305 (€281)  billion spent annually on overpriced products.

China’s car association announced Friday that vehicle sales in China are down 92% in the first half of February. Only 4,909 cars were sold, down from 59,930 in the same period a year ago.

Globally, financial bourses were steady on Friday, 21 February 2020.

American investors have been especially sanguine about Covid-19. The broad stock market index in the US, the S&P 500, is up 5.6% since news of the outbreak became known. The New York Times commented on Thursday: ‘U.S. stock investors seem to be betting that the Fed will bail them out of any damage to corporate profits and the world economy.”

21 airlines have canceled all flights to mainland China. Air travel with China is down over 70% from before the virus struck. Air traffic within China has been cut in half.

On Friday (21 February 2020), the International Air Transport Association announced its forecast that global demand for air travel will drop 4.7% in 2020, costing the airline industry $29.3bn (£23.7bn) in lost revenues. Unsurprisingly, the biggest downfall in air traffic will be in China.

After 2 weeks in quarantine, cruise ships in Asia which have had infected passengers or crew have released those who have not shown symptoms. Some have questioned whether those releases were prudent.

Cruise ship lines have now shut down their excursions in Asia. The cruise ship industry is $45 billion business. China has been one of the travel industry’s biggest growth markets in recent years, and, trips in the Asia-Pacific region are ~10% of the industry.

Conferences and sporting events around the world are being postponed or canceled out of fear of contagion, with new announcements nearly daily this week. Such events generate more than $1 trillion in associated spending: travel, hotels, and catering.

The semiautonomous Chinese territory of Macau reopened its casinos Thursday, ending a 15-day closure aimed at stemming contagion from spreading further in the city of 670,000 – even as the government continues to urge people not to congregate.

North Korea announced Friday that it was canceling its annual international marathon, held in April. North Korea closed all its schools for a month on Thursday.

Wednesday, North Korea said it was going to hold its annual mass gymnastics show this summer. The show usually draws many foreign visitors. North Korea has so far not confirmed a single case of the virus. To prevent contagion, the country has cut cross-border transport routes and ordered month-long quarantines for recently arrived foreigners.

Tokyo’s Governor Yuriko Koike said Friday that her government would cancel or postpone many large-scale official events for the next 3 weeks to prevent the spread of Covid-19. Tokyo reiterated today that it will host the Olympic Games in July & August.

Background:

A coronavirus is a subfamily of viruses, so named because they have large bulbous projections from their envelope, which the virologist naming the virus thought resembled a monarchial crown.

“The term ‘protein corona’ refers to the layer of proteins that adhere to the surfaces of nanostructures when they encounter biological fluids,” noted Swedish virologist Kariem Ezzat. These proteins are strategically perched on the outside of a virus, acting as intelligence agents and first-contact specialists. “The importance of the corona layer is that it constitutes the actual surface of interaction with biological membranes or ‘what the cell sees’,” explained Ezzat.

Various coronaviruses are widespread among birds and mammals. There are 7 known strains of human coronaviruses. Like all other viruses, coronaviruses opportunistically speciate by adaptively acquiring (via infection) or problem-solving new proteins which provide better tools for infection.

Many mammalian coronaviruses originated with bats. Humans first encountered coronaviruses roughly 2 centuries ago from eating infected cattle. Modern outbreaks of new variants typically happen from eating infected animals.

Coronaviruses primarily infect the upper respiratory and digestive tract of mammals and birds. In people, coronaviruses are responsible for an unhealthy percentage of common colds. Coronaviruses also cause pneumonia and bronchitis.

Coronavirus disease was first described in 1931, with the viruses themselves first seen in 1965, having been taken from the nasal cavities of people with the common cold and put under an electron microscope.

Most coronaviruses are not dangerous. But those that cause Middle East respiratory syndrome (MERS), SARS, and now Covid-19, can be deadly.

Besides the ability for human-to-human transmission, Covid-19 is clever enough to delay symptoms from appearing for 14 days, thereby making it easier for infected victims to spread the disease. This viral savvy is termed asymptomatic infection.

Early symptoms of Covid-19 include dry cough, sore throat, shortness of breath, and fever.

People are typically sick for a week from the seasonal flu. 2019-nCoV has its victims out of action an average of 24 days.

The Washington Post on who is at the most risk from Covid-19: “So far, the risk factors for developing severe illness are thought to be similar to those for other respiratory illnesses. Older people and those with underlying illnesses, such as diabetes or high blood pressure, are at increased risk. Early studies have also suggested men are at greater risk.

“But there can be tremendous individual variation in how people respond – as with other diseases. There will be people with known risk factors who recover, as well as people who develop severe cases for reasons we don’t understand.”

The common flu kills roughly 400,000 people every year. Covid-19 has shown itself to be more lethal than the common flu. Other coronaviruses have had far higher mortality rates than the common flu, and have also led to global epidemics.

Viruses, including Covid-19, can typically transmittably linger on surfaces for many hours, and are infectiously picked up (fomite transmission). Covid-19 is not known to be airborne, though Chinese epidemiologists are starting to wonder about that.

Infectiousness – what epidemiologists call reproductive ratio (R0 (pronounced “R-naught”) – is a mathematical estimation of how easily a pathogen spreads. The SARS virus had an R0 of 0.5, meaning that every 2 cases of SARS resulted in only 1 additional infection. Covid-19 is estimated to have an R0 of 2.6: producing fewer than 3 new cases for each initial infection. This estimate is preliminary. An R0 of 2.6 is higher than the seasonal flu virus, which has an R0 of 1.3. For perspective, measles has an R0 of 12 to 18.

“It’s very, very transmissible, and it almost certainly is going to be a pandemic,” says American epidemiologist Dr. Anthony S. Fauci. WHO director Tedros Adhanom Ghebreyesus echoed that sentiment Monday (10 February 2020): “In recent days we have seen some concerning instances of onward transmission from people with no travel history to China. The detection of this small number of cases could be the spark that becomes a bigger fire.”

Chinese epidemiologist Gabriel Leung reports that “those most at risk of infection includes older adults, the obese and people with underlying medical conditions. There are few reports of children becoming infected.”

SARS had a mortality rate of 9.6%; 774 people died. Only ~2% of those reported to have been infected with Covid-19 have died. The 1918 “Spanish flu” killed only about 2.5% of its victims, but because it infected so many people and medical care was much cruder then, 20-50 million died.

“The effects of a pandemic would probably be harsher in some countries than in others,” noted health reporter Donald McNeil Jr. The quality of national public health systems will be telling in the toll that Covid-19 takes.

Chinese and Western researchers link SARS-CoV-2 to the pangolin (pictured below), a mammal illegally trafficked in huge numbers for the reputed (but superstitious) healing qualities of its scales and meat. The Chinese government is belatedly cracking down on the wildlife trade believed to be behind the viral outbreak. On Monday 17 February 2020, Chinese president Xi condemned the “major hidden danger” of eating wild animals.

There have been hoax reports of SARS-CoV-2 being engineered in a Chinese lab – a claim which has been disproven. The Guardian reports on 20 February 2020: “World-leading experts on the novel coronavirus have signed a statement of support for their Chinese colleagues, who are being attacked on social media and even threatened with violence as false rumors circulate about its origins.”

The SARS coronavirus in 2002 probably originated in bats and spread to humans through the civet cat, which was sold in wildlife markets and eaten as a delicacy in southern China.

Covid-19 opportunistically adapted much faster than SARS did. It took SARS 3 months to mutate to human-to-human transmission; a feat that took Covid-19 only 1 month, according to Chinese epidemiologist George Fu.

Saltation is the attribution evolutionary biologists use for organisms which make seemingly sudden evolutionary leaps. Turtles are an example of saltation, in having suddenly appeared in the fossil record (bones being well preserved, proto-turtles would have been discovered). The striking varieties of orchids is another example of saltation. In its rapid adaptations for asymptomatic infectiousness and prolonged virulence, SARS-CoV-2 looks to be a viral example of saltation.

There are no vaccines or antivirals in routine clinical use for coronaviruses. Japan announced on Tuesday, 18 February 2020 that it was going to test HIV medication as a potential treatment for Covid-19. On Wednesday, 19 February 2020, Johnson & Johnson joined Sanofi Pasteur in announcing work on a vaccine. “I think companies are looking at it in a way they hadn’t looked at it before because I think the disease itself is convincing people this has a potential to be around for a while,” said American public health administrator Michael Osterholm.

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Coronavirus diagram courtesy of Crenim.