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There is still reason to believe the growing coronavirus outbreak in China can be contained, a top World Health Organization official said Saturday, pointing to some evidence that the disease may not be spreading as rapidly as is feared. He also downplayed reports that people infected with the virus may be contagious before they show symptoms — a feature that, if true, would make it much harder to control.

“Until [containment] is impossible, we should keep trying,” Dr. Mike Ryan, head of the WHO’s Emergencies Program, said in an interview with STAT. The WHO declared the outbreak a global health emergency on Thursday.

The gargantuan efforts China is making to try to halt the spread of the virus is buying the rest of the world “precious lead time” to prepare for the possibility they might have to cope with it as well, he said: “We need to thank China for that opportunity.”

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“That is not to say that the disease won’t get ahead of the Chinese authorities completely or get ahead of the other countries that are containing it,” Ryan said. “But there’s enough evidence to suggest that this virus can still be contained.”

For instance, data from some studies in China looking at how much transmission occurs when the virus gets introduced into a household suggests the secondary attack rate — the number of people the first case infects — isn’t that high. “But that’s obviously a few studies across a very large event,” Ryan cautioned.

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There haven’t been many reports of health worker infections, a feature that fueled the earlier outbreaks of SARS and MERS, coronaviruses that are related to this new pathogen, provisionally called 2019-nCoV. Likewise, there has not been a lot of spread from cases discovered in other countries in tourists from China or people returning from China.

Still, numbers of cases are growing in big leaps — China reported 2,102 new cases and 46 additional deaths on Saturday. And those numbers might be higher still but for the fact that China has a backlog of tests to be processed. Ryan said the problem isn’t testing reagents — the country has indicated it has adequate supplies — but the sheer number of tests that need to be run.

“So there are clear indications obviously that the disease numbers are growing. But there is also some contradictory evidence as well that doesn’t completely align with the kinds of R0s that are being estimated,” Ryan said.

R0 — pronounced R-naught — is the reproductive number of a disease, the number of people, on average, each infected person goes on to infect. Most studies so far have estimated the R0 in this outbreak to be between 2 and 2.5, which is higher than seasonal flu — about 1.3 — but lower than SARS, which had an R0 of between 2 and 5.

Ryan would not say what circumstances would lead the WHO to declare this event a pandemic — an outbreak that might be expected to spread around the globe. That kind of discussion, he said, would be a distraction.

“If that becomes the discussion, then we’re all going to lose focus,” Ryan insisted. “We have to remain laser-focused on containment and slowing down the spread of disease.”

As of Saturday, he said, the world has seen nearly 12,000 confirmed cases, all but 133 of them in China. Nearly two dozen countries outside of China have diagnosed cases. The United States has reported eight cases, one of which contracted the virus in this country from a relative who had traveled to China. The latest U.S. case, confirmed on Saturday, is a University of Massachusetts Boston student in his 20s who returned from a visit to China on Tuesday.

The Trump administration declared the outbreak a public health emergency on Friday, saying it would temporarily bar entry to Chinese nationals who had been in China in the past 14 days and would quarantine Americans returning from China. On Thursday, the State Department told Americans not to travel to China.

There have been a total of 259 deaths reported so far, all in China. “Almost all of the mortality is in the over 40s,” Ryan said “and a strong preponderance of males.” About a third of the cases have pre-existing health problems.

One of the concerns about this outbreak has been reports that people may be able to transmit the virus before they develop symptoms — which, if true, would make containment tools like quarantine less effective than they were during the 2003 SARS outbreak.

A report published Thursday in the New England Journal of Medicine pointed to this type of transmission, sometimes called asymptomatic spread, in a cluster of cases in Germany.

But Ryan said the data the WHO are seeing suggests some people who have been publicly labeled “asymptomatic” were actually already experiencing some symptoms.

“We still believe, looking at the data, that the force of infection here, the major driver, is people who are symptomatic, unwell, and transmitting to others along the human-to-human route,” he said. “That is the pressure wave.”

Ryan admitted he was surprised by the speed with which the outbreak has taken off. China alerted the WHO to the fact that it believed a new virus was causing pneumonia in the central Chinese city of Wuhan on Dec. 31. On Jan. 7 it announced it had isolated a new virus.

The total number of confirmed cases in this outbreak — just a month old — has already surpassed the SARS outbreak, which played out over a period of at least eight months in 2002-2003.

“For me it’s been unusual to see a new disease emerge and, on the face of it, move so quickly,” he said. If the scientists studying the genetic sequences of the viruses are right and the outbreak began sometime in late November or early December, “then this is a very rapid emergence and very rapid infection of a lot of people.”

  • China is being cut off by the world. It seems WHO should have already announced an epidemic. If neighbouring countries fail to contain the infection, the infectious area expands, and will continue increase rapidly. Even if a vaccine is found, or the tamiflu & hiv rumour is true, there still is not enough to administer to the thousands that are in need, same as flu season when tamiflu was in short supply. I believe the actions by the Pentagon and airports and images seen in China speaks volumes. All this other talk, is to reduce panic. China had said expect an explosion of symptomatic cases in 10 days, I’m counting down. And I’m not counting on anyone to save us. WHO are working off data supplied by China. I’m finding it hard to find updates etc as it seems Google and the media have been suppressed and social media is flooded with traffic. But we’ve all seen enough. stay safe people

  • Is there any medicine to cure the disease?Anybody who could reslove the critical world issue will be prised highly

    • It would take years to develop with testing etc then the mass production. It was reported Thailand used Tamiflu and HIV drugs, but even then, if this explodes there won’t be enough to go around. Just like tamiflu shortages experienced last year.

  • Why is there an emphasis on “human to human transmission outside of china”, is the human to human transmission inside of china not relevant and reason enough for the WHO and the rest of the world to be very concerned about this?

    • You’re right. I guess the WHO messaging to us, outside of China, is focused on changing local priorities, not global priorities. But you and I can worry and care globally.

  • Why are WHO praising the efforts of the Chinese government. If it were not for them downplaying and hiding the truth and for actually having disgusting live animal selling as they do then things would not be as bad or may never have happened. The Chinese government are at the heart of this crisis so call them out on it don’t praise their lacklustre efforts.

    • 1. Wild animal selling (no matter live or dead) is forbidden in China. Just like opioids are forbidden in the USA, still so many people buying them and selling them.
      2. H1N1 was started in the USA. Little efforts were made by the USA government to stop the spread of the virus. It killed 284,500 worldwide and affected 214 countries. Compare this to the efforts of China to contain the novel coronavirus then you will know why WHO praised them.

    • @jules below states wrong, H1N1 actually started in Mexico. Anyway, they did delay it and it seems they were spending all of that time confirming it but Actually moving forward with any containment. However with the rate of spread this has already had, it would have only taken a few people in an airport for this to go global.

  • I have a 38 year-old son in Bejing. He teaches children. Are all schools closed and if so, for how long.

    Any specific data on infection rate of males vs females and any clue as to why it’s affecting males more.

    Are N95 masks available in Bejing and if so where and through what agency.

    Thanks so much.

    • There are more males in China because of the one child policy. This was on the news years ago. Now it is two child policy.

    • Most schools are closed indefinetly. Many have shifted to online courses, though the online course software providers are struggling to meet demand.

    • Regular masks protect against splatter from coughs and sneezes. They also reduce face-touching, which is part of the eyes-nose-face- hand-doorknob-hand-face mode of transmission Of colds and flu. N95 masks stop 95% of floating infectious “dust motes” like chickenpox and other truly “airborne” diseases. Usually cold viruses are spread by droplets, and regular masks are fine. I don’t know if the “novel” Coronavirus requires normal “droplet precautions “ or the more unusual “airborne precautions.” BTW, the N95 masks aren’t 95% effective unless you fit them right and tight. Ask a doctor or nurse how.

  • It’s not bad, we can contain it. It might not be that people can spread it before they are sick even though we have evidence of that happening. The Ro might not be as high a SARS but wow, it’s spreading faster than SARS, it’s spreading at an incredible rate. But you don’t have to worry because it’s not that contagious.

    • Will have to see about secondary transmission outside of China. The Toronto and Illinois cases should tell us quite a bit. In Toronto, a woman sought testing and treatment, and was told she was negative. She then circulated in the community for some period of time. Did she infect anyone else?

      In Illinois, a man acquired the virus from his wife, who had been in China. He then traveled widely. Did he infect any others?

    • @Adam, in the case of Germany, there is already a second generation and maybe third generation infection. The last case was a child of one of the those employee that got infected.

  • Question for Mr. Ryan: when did WHO learn of the problem, and what did WHO do about it. That organization hasn’t covered itself in glory recently.

    • The article says “China alerted the WHO to the fact that it believed a new virus was causing pneumonia in the central Chinese city of Wuhan on Dec. 31. On Jan. 7 it announced it had isolated a new virus.” So I guess there’s your answer in terms of when WHO found out about it. In terms of what they’re doing about it, it seems now that they are mainly focusing on studying the virus and how it spreads – containment being the main goal. But I don’t have any specifics on that.

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