Coronavirus: Cases in China surpass SARS epidemic with over 7,000 infections, WHO calls for emergency meeting
The total number of people infected in China with Wuhan coronavirus has now surpassed cases of SARS — severe acute respiratory syndrome — in the country. The death toll has risen to 170 in China, with 7,711 cases reported within the country.
The number of people who have died in China in the current outbreak is, however, lower as compared to SARS currently. During the 2002-2003 SARS outbreak, 5,327 people were infected in China, and there were 349 deaths. Globally, the total number of people infected with SARS was at least 8,422 and there were 916 deaths, says the World Health Organization (WHO).
Of the new deaths in the 2019 Novel Coronavirus (2019-nCoV), 37 were in the epicenter of the outbreak in Hubei province and one in the southwestern province of Sichuan. On January 29, WHO said that outside China, there are 68 confirmed cases in 15 countries. This number is estimated to be 91 as of January 30.
According to Dr Tom Koch, adjunct professor, Department of Geography, The University of British Columbia (UBC), Canada, the number of infections outstripping SARS is significant, but not necessarily worrisome.
"This virus's expansion has largely been in China. Its movement from Wuhan to other cities during the New Years' travel period isn't surprising. Its expansion elsewhere, given the incubation rate, isn’t surprising," Dr Koch told MEA WorldWide (MEAWW).
He explained, "The numbers infected globally are a testimony to the robustness of the virus. But its mortality rates remain relatively low and we are now far more prepared in Canada and elsewhere than we were in 2002-2003. So it’s kind of not surprising, almost expected, but not as yet a matter of more than vigilant concern."
Experts have previously cautioned that the virus figures could be under-reported. The current Wuhan coronavirus figures cover the previous 24 hours and represent an increase of 38 deaths and 1,737 cases. On January 29, according to available figures, the Wuhan coronavirus had killed 132 and infected 5,974.
"The mortality rate seems to be about the same in China as influenza by my calculations. It isn't a 'killer' pandemic. So health officials are doing what they are supposed to, identifying and isolating suspected cases. Tracing their ties both to those who have the virus and those who may have been infected by them. And then, monitoring," Dr Koch tells MEAWW.
Dr Koch, however, says that many questions need to be answered before experts can assess the danger.
"What we know is still outweighed by what we don’t know. We are not yet certain of the incubation rate — estimates are 1-10 days. Knowing that will say a lot about its transmission. We don’t know its mortality rate. My estimate is based on cases in China but it’s incomplete. We believe it begins with a virus that jumped from snakes and a mammal to humans. But again, we’re not quite sure. We don’t know if patients who recover will have long term effects. So it’s a matter of the slow accretion of knowledge as we do our base with practical public health and epidemiology to at once control and study the epidemic," he explained.
WHO to decide if it's a public health emergency
The World Health Organization (WHO) has called for an emergency committee meeting on January 30. The experts will decide if the outbreak is a public health emergency of international concern.
Dr Tedros Adhanom Ghebreyesus, Director-General of WHO, tweeted on January 29: "I have decided to reconvene the International Health Regulations Emergency Committee on the new #coronavirus (2019-nCoV) tomorrow to advise me on whether the current outbreak constitutes a public health emergency of international concern."
The decision to reconvene the meeting is based mainly on the evidence of increasing numbers of cases and evidence of human-to-human transmission that has occurred outside of China.
When asked why the outbreak had not yet been declared a public health emergency, Dr Koch told MEAWW, "There are very specific criteria for a disease to be described as a public health emergency of international concern. Obviously, it is an emergency in China but its incidence elsewhere has not met that experience. And its mortality rate seems below the threshold. So, the WHO is watching and learning, as we all are. And it may later upgrade the status of the virus depending on how it works out."
These developments in terms of the evolution of the outbreak and the further development of transmission are of great concern and have spurred countries into action, said Dr Michael Ryan, Executive Director, WHO Health Emergencies Programme, during a press conference on January 29.
"What we know at this stage is that it is still a very active outbreak and information is being updated and changing by the hour. It is clearly still centered in China, with the overwhelming majority of cases still being reported from China. However, there are 71 cases reported in 15 other countries," Dr Ryan told the media on January 29.
Dr Ghebreyesus met President Xi Jinping of the People's Republic of China in Beijing on January 28 to assess the situation.
"Stopping the spread of this virus both in China and globally is the WHO's highest priority. We appreciate the seriousness with which China is taking this outbreak, especially the commitment from top leadership, and the transparency they have demonstrated, including sharing data and genetic sequence of the virus. WHO is working closely with the government on measures to understand the virus and limit transmission. WHO will keep working side-by-side with China and all other countries to protect health and keep people safe," Dr Ghebreyesus said in a statement.
The two sides also agreed that WHO will send international experts to visit China as soon as possible to work with Chinese counterparts on increasing understanding of the outbreak to guide global response efforts. The expert team will work in collaboration with Chinese experts to better understand disease transmission and clinical severity.
On January 28, top US health officials told the media that China had declined an offer to send experts from the US Centers for Disease Control and Prevention (CDC) to help with the outbreak response.
"On January 6th, we offered to send a CDC team to China that could assist with these public health efforts. I reiterated that offer when I spoke with the Chinese minister of health on Monday (January 27) and (it) was reiterated again via the WHO's leadership today (January 28) in Beijing. We are urging China more cooperation and transparency are the most important steps you can take toward a more effective response. Beyond that all options for dealing with infectious disease spread have to be on the table, including travel restrictions," US Health Secretary Alex Azar said during the press briefing.