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There are worrying signs the coronavirus outbreak is entering a new phase, with spread outside of China — until recently at low levels — beginning to rapidly pick up steam.

Experts point to the sharp rise of the number of cases in South Korea, which went from 30 on Monday to 204 by Friday, and in Italy, which had no cases at the start of Friday and 16 at the end of it. Five of the infected people in Italy are health workers.

Iran — which began the week with no confirmed cases and ended it with 18, four of whom have already died — is a particular source of concern, having exported two cases within 36 hours of announcing it had found two patients infected with the virus. A traveler from Canada and another from Lebanon tested positive for the virus after returning home from Iran.

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The fact that Iran is already exporting cases suggests transmission there is far more widespread than the official numbers would indicate, said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Diseases Research and Policy.

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“I think people are missing the importance of a case like the Canadian traveler to Iran,” he said, referring to a case reported by health officials in British Columbia on Thursday. “This tells us that there has to be a much larger number of people infected in Iran and we’re literally just detecting the tip of the iceberg.”

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Even Iranian health officials acknowledged that likelihood. “It’s possible that it exists in all cities in Iran,” health ministry official Minou Mohrez said, according to the official IRNA news agency.

Tedros Adhanom Ghebreyesus, director-general of the World Health Organization, resisted the notion Friday that the outbreak was at a tipping point. But he did tell reporters that the “window of opportunity” to stop spread of the virus is shrinking.

“Our window of opportunity is narrowing,” said Tedros, as he is known. “We need to act quickly before it closes completely.”

The WHO has been seeking funding to help developing countries prepare to cope with the outbreak and has been urging countries to prepare their health systems to respond, if efforts to stop spread of the virus fail.

“This outbreak could go in any direction. It could even be messy,” he warned. “What I’m saying is: It’s in our hands now. If we do well within the narrowing window of opportunity, we can avert any serious crisis. If we squander the opportunity, then there will be a serious problem on our hands.”

As of Friday there were nearly 77,000 cases reported globally, with all but 1,200 reported by China. There were also roughly 2,350 deaths.

The growth in the daily case count in China has been tamped down of late by the country’s extraordinary quarantine effort. Cities that are home to tens of millions of people have been on virtual lockdown for several weeks. While the apparent impact of those measures has instilled hope in some that there is still time to stop circulation of the virus, skeptics warn that disease levels in China could rebound when the country eases its movement restrictions and allows people to return to their jobs.

Most of China’s cases have occurred in Hubei province, where the outbreak appears to have begun in the city of Wuhan. But Tedros noted that there has been a worrying uptick in cases in Shandong province; he said the WHO is asking China for more information about that situation.

Gary Kobinger, director of the Infectious Disease Research Center at Laval University in Quebec, also said Friday he believes stopping the virus is still a possibility. Kobinger is on an expert committee that advises the WHO’s Health Emergencies Program; the group wrote a recent letter to the journal The Lancet urging the world to continue to try to stop spread and eliminate the virus, as was done with the virus responsible for the 2002-2003 SARS outbreak.

“We’re not at the tipping point to say ‘OK, this is now unstoppable.’ I don’t think we are there yet, personally,” Kobinger told STAT. “We’re definitely in a grey zone where you could argue both ways and be wrong or right both ways.”

Osterholm and others suggested overly narrow testing protocols are obscuring the world’s ability to see how far the virus has spread. In the United States, for instance, the Centers for Disease Control only recommends testing people who have symptoms and have been to China or who have symptoms and have been in contact with a suspected or confirmed case.

“Basically if you get tested and you’re found and you’re positive, then we know. But how many people right now are not being tested who are just like this case in Canada?” he asked.

If the Canadian doctor who caught the country’s most recent case had been following that type of protocol, the woman who returned from Iran would not have been tested for Covid-19, the disease the new virus causes.

Bonnie Henry, British Columbia’s provincial health officer, said an astute emergency department doctor ordered the test because of the woman’s recent international travel. It turned out to be a good call.

“It is not something we are recommending … but we have had a low threshold for testing and the lab will test if there is a request from an emergency room with compatible symptoms,” Henry said.

Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said Friday that the agency may broaden its recommendations for who should be tested if spread in countries outside of China continues to grow.

With the rapid upswing in cases in multiple countries, a number of experts are warning the world needs to plan for wider global spread of this virus.

“We need to start with assumption that we will be facing a pandemic,” said Caitlin Rivers, an assistant professor of epidemiology at the Johns Hopkins Center for Health Security. “If that doesn’t come to pass, then great. But I think we have an opportunity to learn from the lessons that we’re observing in Hubei province. And it’s in our best interest to lean in on that.”

Andrew Joseph contributed reporting.

  • Now that we know that the virus survives on surfaces why aren’t we fighting it with the new Xenex machine which can sterilize a hospital room in only a few minutes? And why when 50% of our VA hospitals are using the machine hasn’t the military bout the machines to fight the threat of a pandemic?

  • 1. Hold aside death rate. Focus on hospitalization rate. Chinese are saying 20% are severe or critical. If 20% need to go to hospital, any breakout will quickly overwhelm hospitals.

    2. The key to forestalling crisis is to put everyone on quarantine far earlier than they did in Wuhan.

    • I think 8 or 9 of Singapore’s 89 patients have been to the ICU, around 10%. It’s likely a couple more will go to the ICU, so the final percentage may be around 15%, or a bit less.

  • WHO complacent attitude since the beginning contributed to the problem. If the virus stays with us forever like flu and common cold, it can mutate and become more deathly.
    Should that be the case, WHO needs to be eliminated and replace with a new non political and nimble group.

    It is repeating the same mistake it did with ebola, unfortunately with a more deadly consequences.

    Tedros sucking up to China had contributed immensely to the problem. He was against travel ban when several countries implemented it. Had WHO declared that this is a global health problem early on, most countries will close the border early on.

    But WHO does not want to offend China so they drag their feet as long as they can.

    Eliminate WHO and replace it with a nimble and responsive organization. Keeping WHO create the false security that all is well while things are progressing drastically under the radar. It give people a false sense of security.

  • This is only the start or the beginning of The Antimicrobial Resistant Super Bugs That The World Health Organization [ W. H .O ] Compiled And Published in The Year Of 2014 once more Titled Antimicrobial Resistant Super Bugs that would from the year of 2015 killed tens upon tens of thousands of people to the year 2020 and cost one Hundred Trillion Dollars to The Year 2030 Globally in two hundred fifty seven pages of reports so documented . Yes with all of these and more the Circus hypocrite of The Climate Change Alarmist played this and more down . even right now they are doing so . we are finish .more to come Trevor . Merchant .Bronx . New York City . Friday ., February . 21 . 2020 at 4. 36 p.m Eastern Standard Time .

  • Really?? you don’t think this is a Bio-weapon?
    then you must really be stupid!
    what Chuck Biscutts wrote is beyond SPOT-ON SPOT-ON
    WAKE UP AMERICA

  • When you have other countries (including the US) considering themselves at “low risk” , from a highly contagious pathogen which we know very little about – everyone’s guard is pretty much down. “Its not going to happen here” or “I won’t get it” – are famous last words with little bearing on truth or reality.

    While everyone may want to feel immune to the possibility of contracting this new virus; the biggest failures are coming from inadequacies in the health system. We do not fully know if the virus has taken a foothold in the US or not, because hospitals are not testing those exhibiting flu like symptoms where the test for flu came back negative, for the coronavirus.

    As per the report made last week, they are only going to be doing this at select hospitals, when in truth it should have been done by all hospitals at the very beginning of this thing. This is gross negligence in the face of a dangerous pathogen, one for which – we may pay dearly for.

  • I would rather every person in the United States get the virus than one person suspect a Chinese person could carry the virus. (This is the logic of the tards in charge)

  • Good article. The Iran situation is certainly concerning. One hopes that their health authorities suspected the outbreak starting a week ago or longer and have been tracing contacts rigorously. But they really aren’t signaling the kind of strict measures that China put in place and which are almost certainly needed to contain it if they are already in the local transmission phase.

    • This is out of control in Iran. Of course, the authorities knew about it, but they had other priorities.

      The virus will likely infect a substantial portion of the population in Iran. Most patients who require intensive care will die. Many doctor and nurses will become infected.

      Iran’s borders are porous. People will flee, and spread the infection to neighboring countries.

      The one saving grace is that Iranians aren’t big smokers, only about 20% of men.

  • Unbelievable. People will die. The idiots in charge worry more about fake, nonexistent racism against Chinese rather than protect it’s people. PC is deadly. Unreality is deadly. Everyone will see when people they love die or they die.

  • 45 minutes ago

    I think the most important fact that people are not accepting is this virus is not like any other as it is a biological weapon that has been unleashed uncontrollably onto mankind. Not only is it a man made biological weapon but it is an agent designed to provide a gain of function to coronavirus for efficient spreading in the human population. Gain of function technology is DNA genetic engineering of a dangerous biological warfare substances designed to eliminate large numbers of people. This is not like anything mankind has had to deal with thus far because it is not naturally occurring as was other pandemics. This is why you are witnessing the pure panic by the Chinese Government and the outright desperation they have portrayed to try and stop it. What is really disturbing about all of this is the WHO and the CDC know exactly what we’re dealing with here and nobody is willing to come clean. Put into another way of looking at it do you think the World would be horrified to find out that anthrax was spreading uncontrollably across the Globe and will soon be showing up in your backyard? This would cause mass panic and pandemonium unlike anything we have ever witnessed before and the true horror of such an event would dwarf the reaction people were experiencing after 9/11 . Well unfortunately this is exactly what we’re dealing with here because nobody knows the true extent of damage this agent could cause to the human population. Up until recently this outbreak has been labeled nothing more then a serious case of the flu that can lead to pneumonia. However as more information has been leaked now people should start being able to put this dire situation more into perspective as the numbers keep multiplying on a daily basis. Now you take all that and read an article like this where those infected are becoming reinfected within 10 days? Clearly with an incubation period of up to 14 days or now possibly 30 days it appears that those infected actually didn’t get rid of the virus at all it just went momentarily dormant which allowed for the negative results. With the SARS and especially the HIV proteins found in this virus it is very possible that it can never be cured as we still have no cure for HIV thus far. It is very likely that people being released are still infectious and still have the ability to spread the virus even though they test negative. This all goes back to the reality that this is a bioengineered weapon of mass destruction because gain of function technology is DNA genetic engineering of dangerous biological warfare substances. So for anyone to sit back and think this isn’t going to have a negative impact on the entire planet is rediculous. I find it very disturbing that ordinary people like us can uncover the truth and understand the true magnitude of this situation yet organizations like the WHO and the CDC pretend like it’s no big deal. It’s pretty obvious to me that they know full well what we’re dealing with but are unwilling to share the true information with the public in order to prevent mass panic and fear. Their sole responsibility is to protect the well being of its citizens and inform them on how to prepare for an upcoming crisis so they can protect themselves and their families. The small window of opportunity the WHO Director describes has already been breached as these very organizations covered up the truth for too long and has allowed for this to spread uncontrollably. We need to know the truth about what we’re dealing with here because millions of lives are at stake. I want to see the scientists that engineered this Bioweapon come forward and let us know our true fate. Trying to kick the can like every lying Government does isn’t going to work this time as people are dying everyday and they don’t even have a cure for the common flu or HIV never mind a weaponized virus designed for mass elimination of humans. They know full well this Pandemic is creating a strong foothold here in America and other Countries around the world. Stop using gag orders to suppress information by using peoples so called HIPAA Rights and just tell the damn truth already so people can prepare for what may lie ahead. Trying to protect the Financial Markets and the economy over the health and wellness of its people is criminal. What difference does it make if you protect the Financial Markets if everyone is either dead or infected none of that will really matter at that point…

    • The above comment proves that we have a crisis of irrational thinking on our hand. This person believes it’s a bioweapon without any evidence but write a wall of text as if it were fact

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