Call for overhaul of early warning process as coronavirus deaths hit 1,115

A patient suspected to have contracted coronavirus is seen at Nakhon Pathom Hospital in Nakhon Pathom on Thursday. (Reuters photo). Sketched by the Pan Pacific Agency.

BEIJING, Feb 12, 2020, SCMP. China’s health authority reported 97 new deaths attributable to the coronavirus, which has now been officially named Covid-19, and 2,015 newly-confirmed cases as of Tuesday. This brings the national totals to 1,113 and 44,653, respectively. As of Tuesday, 744 recovered patients have been discharged, while the total number of recovery cases stands at 4,740, South China Morning Post reported.

Outside Hubei province – epicentre of the Covid-19 epidemic – new infections on the mainland fell for the eighth consecutive day.

A group of scientists has called for changes in the way new viruses are reported, to address the delay which occurred between the first indication of a new coronavirus strain in Hubei province and the release of critical information about its genetic make-up to the global health community.

In a letter to The Lancet on Tuesday, the group called for a new reporting system that takes into account the speed of current next-generation sequencing.

Two of the letter’s authors sit on the World Health Organisation’s International Health Regulations Emergency Committee, which provides advice about when to declare a public health emergency of international concern. That status was given to the spread of the novel coronavirus on January 30.

The letter pointed out that preliminary sequence data indicating the presence of a Sars-related coronavirus was obtained by researchers on December 26, but it was more than two weeks before the critical information about the virus’ genetic make-up was released to the global health community.

The scientists questioned whether the use of traditional reporting patterns for the discovery of new pathogens had slowed down the reporting process. They suggested an overhaul which could allow scientists to report the presence of disease-causing agents before the agent had been isolated.

“The Chinese authorities ruled out Sars and Mers, as well as a few other non-coronaviruses, on January 5, and confirmed a novel coronavirus as a potential cause on January 9. However, the genome sequence – crucial for rapid development of diagnostics needed in an outbreak response – was not released until January 12, 17 days after the preliminary sequence data were obtained,” they wrote.

The scientists also recognised the “crucial role” of clinicians and scientists in the early detection of the outbreak in China, noting this role was not only played by doctors reporting cases in their wards, but by “eight doctors who were wrongly accused of spreading ‘fake news’” after sharing information about the outbreak online – a reference to a group that included Li Wenliang, the doctor hailed as a whistle-blower who later succumbed to the disease.

“Now is not a time for blame. Rather, there are lessons the global health community can and should learn and act on so that we can better respond to the next EZV (emerging zoonotic virus) event, which is almost certain to happen again. These lessons are definitely not unique to China,” they wrote.

Tibet patient cured

The only new Covid-19 patient in Tibet was cured and discharged from hospital on Wednesday afternoon, People’s Daily reported, citing the patient’s doctor Hua Demi from the Third People’s Hospital of Tibet.

The patient, a 34-year-old man surnamed Zhang from Suizhou, Hubei province, spent three days on a train before reaching Lhasa on January 24. He sought medical treatment a day later and was isolated for treatment. He was confirmed to be infected with Covid-19 on January 29.

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Tibet subsequently closed all its tourist attractions and put anyone entering Tibet under 14 days of quarantine.

Zhang’s tests for the virus came back negative twice on February 9 and 11. CT scans and clinical symptoms showed he had been cured. He left Tibet by train on Wednesday afternoon, according to the People’s Daily report.

Hubei reports 94 new deaths

Health authorities in Hubei reported 94 new deaths attributable to the contagion, and 1,638 newly confirmed cases as of Tuesday. This brings the totals announced by the province’s health commission to 1,068 and 33,366, respectively.

Officials in Hubei had reported 103 fatalities and 2,097 newly confirmed cases a day earlier.
Some 1,104 of the new cases announced were confirmed in Hubei’s capital of Wuhan, where the virus is believed to have originated at a seafood and meat market.

The figures from Hubei on Tuesday mark the lowest number of newly confirmed cases since the beginning of February. It is also the first time that Hubei has reported fewer than 2,000 new daily cases since February 2.

Michael Ryan, the World Health Organisation’s head of emergency programmes, said on Tuesday in Geneva that Covid-19 had the potential to spread faster than either the Ebola or Sars viruses. Earlier this week, Covid-19 exceeded the Sars outbreak of 2002-03 in terms of deaths attributed to it.
Transmission methods have been shown to include human-to-human contact, and the incubation period is believed to be up to 14 days.

In recent days, epidemiologists have said that the contagion may also spread through “aerosol transmission” – when tiny particles or droplets of the virus suspended in the air are inhaled.

Others indicated that transmissions are possible from patients who show mild or no symptoms.

WHO officials said on Tuesday that the agency had also activated a UN crisis management team to better assess and mitigate the outbreak’s economic implications.

US repeats concern over China’s purchases

The outbreak could have an impact on Chinese purchases of US agricultural products this year under the US-China phase one trade deal, White House national security adviser Robert O’Brien said on Tuesday.

“We expect the phase one deal will allow China to import more food and open those markets to American farmers, but certainly, as we watch this coronavirus outbreak unfold in China, it could have an impact on how big, at least in this current year, the purchases are,” O’Brien told an event at the Atlantic Council.

The agreement was signed on January 15 and includes pledges by China to increase purchases of American products and services by at least US$200 billion over the next two years.

O’Brien said there were no American doctors on the ground in China so far, despite US offers to help fight the outbreak.

“We’ve offered the Chinese the opportunity to have American doctors from CDC and NIH and other experts come to China to help them. That offer has not been accepted at this point but that’s an outstanding offer,” he said.

But US officials said on Monday that China had agreed to allow American health experts into the country.

“China has accepted the United States’ offer to incorporate a group of experts into a World Health Organisation mission to China to learn more about and combat the virus,” White House spokesman Judd Deere said.

In a Tweet on Monday, WHO director general Tedros Adhanom Ghebreyesus said an advance team of WHO experts had arrived in China to “lay the groundwork for the larger international team”.

Iran’s health ministry has denied a report that an Iranian woman has died of a suspected coronavirus infection.

The state daily newspaper Iran reported on Wednesday that a 63-year-old woman had died in a Tehran hospital on Monday and that an investigation had been ordered into the cause of her death. No sources were cited in the report.

A spokesman for Iran’s Health Ministry, Kianush Jahanpour, denied the report. “There have been no cases of coronavirus in Iran,” he said.

Iranian health authorities have repeatedly said there were no confirmed cases of coronavirus in the country.

Chinese authorities are considering whether to postpone the country’s college entrance exams, due to take place in June.

“Those responsible for arranging college entrance exams need to put the lives and health of candidates and testing staff first,” Wang Hui, a Ministry of Education official, said at a press briefing on Wednesday. “We will closely monitor the development of the outbreak, evaluate the possible impact on the exams and carefully formulate a plan.”

Additional reporting by Reuters

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