https://www.ft.com/content/c1c92b80-3ec1-11ea-b84f-a62c46f39bc2Containing the spread of the coronavirus is a forlorn hope
A revised timeline suggests it has been circulating longer than first thought
ANJANA AHUJA A military medical team member and a medical worker at Wuhan Jinyintan Hospital at the weekend
The world should be more anxious than it was a week ago. According to research published on Friday, a new Sars-like coronavirus has been present in China since December 1, a full month before the alarm was raised. Almost 3,000 people have been diagnosed with the respiratory illness. As of Monday afternoon, 35 cases were outside China. Eighty-one people have died. Despite draconian quarantining, the virus, provisionally known as 2019-nCoV, is spreading.
Several countries, including the UK, are considering evacuating nationals from the hot zone. It is now time for the World Health Organisation to call a Public Health Emergency of International Concern (PHEIC). The revised timeline on when the virus began circulating comes courtesy of two papers in The Lancet medical journal, which reveal other worrying details. One sets out the clinical data on the first 41 laboratory-confirmed patients. Patient zero, who fell ill on December 1, had no link to the seafood market in Wuhan that is widely assumed to be the source of the outbreak. A further 13 of those 41 cases showed no link either. It is possible that the virus began circulating earlier than December. Other analyses separately suggest that containment is now a forlorn hope. The “reproduction number” is thought to lie between two and four — meaning that, on average, each infected person passes the virus to between two and four others. That is high: seasonal flu has a reproduction rate of about 1.4. The incubation period could be about a week, with infected individuals possibly being contagious while showing mild or no symptoms. Neil Ferguson, an Imperial College epidemiologist, estimated that 4,000 were infected by January 18. Jonathan Read, of Lancaster University, and colleagues provisionally calculate that the tally could exceed 190,000 by February 4. A “grave situation” for China, as President Xi Jinping describes the epidemic, is a grave situation for the world. A fifth of the global population is now potentially exposed to a highly transmissible, currently incurable and potentially fatal respiratory virus.
Richard Horton, editor-in-chief of The Lancet, believes a PHEIC declaration should be considered. “The emergency committee [of the WHO] should reconvene as a matter of urgency,” Mr Horton said, adding that he felt there were political sensitivities at play that have not dogged other epidemics, such as Ebola in west Africa. Recent developments, such as a special committee set up by China’s ruling party, have also heightened rather than allayed his concerns. He says: “Not one [of the people on that committee] has any background in public health. That makes me very worried.” Mr Horton also fears the mass social unrest that may accompany prolonged quarantine with patchy information. It is unclear whether the WHO knew in advance of China’s quarantine plans. The language emerging from its meetings has been painfully diplomatic, with its director-general Tedros Adhanom Ghebreyesus remarking only that he hoped the extreme measures were “both effective and short in their duration”. Sir Jeremy Farrar, director of the Wellcome Trust, said it was “right and appropriate” for China to control the first response. Antivirals were going into randomised trials on the ground, he said, and vaccines might become available within six months. He acknowledged, though, that the social consequences of quarantining millions of people remained “uncharted territory”. All factors considered, it is perverse to see the coronavirus outbreak as anything other than a PHEIC. The writer is a science commentator
