Cesar Chelala
A physician and writer

The coronavirus serious public health threat in China

New York — The happy expectations for the week-long Chinese New Year holidays have been dampened by a new viral infection that is spreading rapidly in China (cases have been confirmed in Beijing, Shanghai, and Guangdong province) and other countries.  Since late 2019, people from Wuhan had been infected with a viral pneumonia whose cause was unknown. Now the virus has been identified as a new type of coronavirus.

Two other types of coronaviruses are SARS and MERS. The new virus is raising concern about the possibility of a new SARS (Severe Acute Respiratory Syndrome)-kind of epidemic, which killed thousands of people in 2002 and 2003. As of now, people infected with this new virus have been found in China, Japan, Thailand, Taiwan, and South Korea. On January 21, 2020, the first case was reported in the United States, in a man who was returning to the U.S. from a trip to Wuhan.

Chinese health authorities are taking serious measures to control what could be a most serious outbreak. A quarantine zone has been established in three cities: Wuhan, Huanggang and Ezhou, confining some 20 million people to their municipalities. This quarantine may soon expand to other cities in China.

Some coronaviruses, first identified in humans in the mid-1960s, cause the common cold, while others -as the found in Wuhan- can cause severe illness leading to death. People infected with the Wuhan coronavirus suffer coughs, fever, and severe breathing difficulties. Although some antiviral drugs may lessen the severity of the symptoms, antibiotics do not have any effect. The recovery of those affected will depend on the strength of their immune system, which is already weakened in the very old and already sick.

The seriousness of the situation is underscored by Guan Yi, a virologist who helped identify the SARS virus in 2003. He believes that an outbreak bigger than SARS is certain, and estimates that it could be 10 times bigger than SARS, which was initially confined to a more defined part of the country. The new coronavirus has now been detected in Harbin, in the north and Shenzhen in the south, and Hong Kong and Macao have also reported cases.

The World Health Organization (WHO) has recommended screening aggressively for the newly found virus. Chinese President Xi Jinping urged public health officials to urgently take appropriate measures for controlling the spread of the infection, saying “party committees, governments, and relevant departments at all levels should put people’s lives first”. The Chinese political body responsible for law and order stated that lower-ranking officials who covered up the spread of the virus would be “nailed on the pillar of shame for eternity”.

Both Chinese health officials and the U.S. Centers for Disease Control and Prevention (CDC) are closely monitoring the situation although it admitted that there is “much more to learn” about how the virus is transmitted. “More cases may be identified in the coming days, including more in countries outside China, and possibly in the United States,” said the agency. “Given what has occurred previously with MERS and SARS, it’s likely that some limited person-to-person spread will continue to occur.”

In the meantime, China’s health commission has indicated that the government will respond with measures appropriate to manage outbreaks of the most virulent diseases, including mandatory reporting of cases. This is particularly important to be able to follow the course of the disease and to concentrate efforts in the most critical areas.

Residents of Wuhan have canceled plans to go out to restaurants for the New Year celebrations, and are avoiding close places like movie theaters and shopping markets. Other residents are leaving the city, saying that they will return when the outbreak is effectively contained. Many people are wearing masks while they join friends to chat or play cards.

Because there is no effective treatment or vaccine to protect against this disease, controlling it relies in prompt identification, management and isolation of possible cases, personal protective measures, limiting crowded places, and investigating close contacts of those infected to minimize potential transmission. No effort should be speared to control this dangerous disease. Good preventive measures can considerably minimize the number of deaths.

Dr. César Chelala, an international public health consultant, is the foreign correspondent for The Middle East Times International (Australia).

About the Author
César Chelala is a physician and writer born in Argentina and living in the U.S. He wrote for leading newspapers all over the world and for the main medical journals, among them The New York Times, The Washington Post, The Wall Street Journal, The Japan Times, The China Daily, The Moscow Times, The International Herald Tribune, Le Monde Diplomatique, Harvard International Review, The Journal of the American Medical Association, The Lancet, Annals of Internal Medicine, and The British Medical Journal. He is a co-winner of an Overseas Press Club of America award and two national journalism awards from Argentina.
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