China: coronavirus cases surge, fuelling fears of major outbreak

Authorities on alert ahead of lunar new year holiday as 139 new cases of strain detected

A mysterious Sars-like virus has spread around China including to Beijing fuelling anxiety about the prospect of a major outbreak in the country as millions begin travelling for lunar new year celebrations.

Authorities reported 139 new cases of the new strain of coronavirus over the weekend, tripling the total number of infected patients since the virus was first detected last month in the central city of Wuhan to 217.

On Monday authorities said cases had been confirmed in Beijing, Shanghai, and Guangdong province in the south, heightening fears ahead of the lunar new year holiday, when more than 400 million people are expected to travel domestically and internationally.

State broadcaster CCTV said on Monday evening there were seven suspected cases in other parts of the country, including Shandong in the east, and the south-western provinces of Sichuan, Guangxi and Yunnan. Five people who travelled from Wuhan were also being treated for fevers in Zhejiang province.

Peoples lives and health should be given top priority and the spread of the outbreak should be resolutely curbed, said President Xi Jinping, weighing in on the matter for the first time.

Coronavirus in China

The strain has caused alarm because of its connection to severe acute respiratory syndrome (Sars), which killed nearly 650 people across mainland China and Hong Kong in 2002-03. Three people have so far died in the current outbreak, which has spread to Thailand, Japan and South Korea.

Chinas National Health Commission said it had sent working groups to all provinces to oversee outbreak prevention, describing the situation as controllable. Hospitals in Shanghai and Beijing and in Zhejiang province have comprehensively strengthened examination procedures. In Shenzhen, temperature checks have been put in place in airports, ports and railway stations.

More than 100 patients with symptoms were waiting to be seen at the Xiehe hospital in Wuhan at 6am on Monday. If you are coming now, you have to wait between three and four hours before you can see the doctors, a hospital worker said by phone.

At a hospital in Chaoyang district in Beijing, patients were being given masks and forms to fill out, detailing any recent travel to Wuhan. A nurse said preventive measures were also being taken to protect doctors

Coronaviruses are transmitted between animals and people and the outbreak in Wuhan has been linked to a now-closed seafood market where live animals were reportedly sold.

One traveller wears a face mask outside Beijing railway station as China reported a sharp rise in the number of people infected with the coronavirus. Four hundred million people are expected to travel for lunar new year. Photograph: Mark Schiefelbein/AP

Authorities have said there is no clear evidence the virus has been spread through human to human contact. Researchers worry the number of infections has been severely underestimated.

The World Health Organisation has said an animal source was the most likely primary source of the outbreak, with some limited human-to-human transmission occurring between close contacts.

Xi Chen, an assistant professor at the Yale School of Public Health, said the likelihood of human to human transmission was large given how many cases were confirmed. Its hard to see all these cases coming from animals at the same market, Chen said.

For weeks, the only reported cases were in Wuhan and areas outside mainland China, prompting many people to question whether other cities were simply not reporting or testing for the virus. Some internet users joked the virus appeared to be patriotic by only spreading beyond Chinas borders.

Chen said the high cost of testing for diagnosis may have contributed to underreporting.

The closed Huanan seafood wholesale market in Wuhan, which has been linked to cases of the coronavirus. Photograph: STR/EPA

Authorities have still not identified the source of the infection, which further complicates the governments ability to contain the outbreak. The Huanan seafood market, where thousands of traders sold products, has been closed since 1 January. But some of the detected cases are patients with no history of visiting the market.

What concerns me is the source of infection. We have no idea. Thats the most important thing. Without knowing that we dont know the harm, how hard it can be, Chen said.

Others fear that authorities have not moved quickly enough to contain the spread of the virus or educate the public. In Wuhan, temperature checkpoints have been installed at the airport and at train stations and bus terminals since 14 January, about five weeks after the virus was first detected.

Observers and residents worry about the possibility of a cover-up, worsening the outbreak, as was the case with Sars in 2003.

Some residents in Wuhan have been told not to speak to media. The official Weibo account of Wuhan police said on 1 January that eight internet users who spread false information online causing adverse social impacts had been dealt with according to the law.

But Chinese health officials have made improvements since the Sars episode. In response to a bird flu outbreak in 2013, authorities quickly worked with the World Health Organization and the US Centers for Disease Control and Prevention. Fresh food markets were shut down but the outbreak was exacerbated by poultry sales into smaller, less-regulated markets.

A quarantine notice about the outbreak of the coronavirus in Wuhan at an arrivals hall at Haneda airport in Tokyo, Japan. Photograph: Kim Kyung-Hoon/Reuters

The situation is complicated by the fact that farmers are unlikely to be compensated by the government or to give up their sick animals.

Its not about a cover-up. Rather its about a lack of capacity and about a lack of enforced regulation, said Nicholas Thomas, associate professor focusing on health security at City University of Hong Kong.

At the moment, it is a bad flu. Yes, it is something to be concerned about and it is probably going to get worse in terms of infections and mortality, but again its winter, he said. It is likely to spread but we are still a long way off the levels of Sars or bird flu.

The state-run Global Times said in an editorial on Sunday: In the early days of Sars, there was a cover-up and delayed reporting. Such things can never be repeated again in China.

Authorities have advised residents in the run-up to the lunar new year, which falls on 25 January, to be on the lookout for symptoms including fever, coughs, breathing difficulties and pneumonia.

Millions of people will crisscross the country during a weeklong public holiday starting on 24 January, in what is known as humanitys largest migration. Some of those travelling will have set off already.

The WHO has not recommended any travel restrictions and Chinese authorities have not yet issued any. Still, not all residents were comforted by government assurances.

With this huge amount of spring festival travel, why are there not any prevention measures? one wrote on Weibo. On the Douban forum, another observed that few people at the Wuhan train station were wearing masks.

Traders at the suspected seafood market in Wuhan said they were not overly worried, seeing the virus as little more than the common cold . We start early, at 2am or 3am. We put our hands in the cold water. If we catch a cold, we dont pay it much attention, said Li, 52, who has operated a stall in Huanan for most of the past decade.

Li said that starting from late December, the property developer that owned the market asked renters to wear masks to work and avoid going to crowded places. Im not worried, said Li. My grandchildren all live in Wuhan and we dont believe it. Its just rumours.

However, Li said some tenants who might have shown symptoms of the virus were unlikely to have reported themselves, fearing the impact on their business and being quarantined. Most people wouldnt say if they had it, he said.

Additional reporting by Lillian Yang

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