There is growing concern that the new coronavirus may be going undetected in Indonesia, where officials have not confirmed a single case of infection among the 272 million-strong population despite the country’s close links to China.
As of Thursday, Indonesia said it had no confirmed cases of the coronavirus and that 238 people evacuated from Wuhan, the centre of the outbreak, had not shown symptoms, although it said they hadn’t been tested.
More than 630 people have been killed by the virus in China, while confirmed infections have passed 30,000 globally. Most cases are concentrated in China, though the virus has been recorded in countries across Asia, as well as Europe, Australia and the US.
A study by academics from Harvard University analysed the number of passengers taking flights from Wuhan to destinations around the world, and found that the number of cases identified in both Indonesia and Cambodia appeared below what might be expected. The study, published quickly to improve scientists’ understanding of the outbreak, has not been peer reviewed, but adds to mounting fears that cases are not being identified.
It also suggested that cases recorded in Thailand, where 25 people have tested positive, were below the number scientists might expect to see. Cambodia has so far confirmed one case of coronavirus.
What is the virus causing illness in Wuhan?
It is a member of the coronavirus family that has never been encountered before. Like other coronaviruses, it has come from animals. Many of those initially infected either worked or frequently shopped in the Huanan seafood wholesale market in the centre of the Chinese city.
What other coronaviruses have there been?
New and troubling viruses usually originate in animal hosts. Ebola and flu are other examples – severe acute respiratory syndrome (Sars) and Middle Eastern respiratory syndrome (Mers) are both caused by coronaviruses that came from animals.
What are the symptoms of the Wuhan coronavirus?
The virus causes pneumonia. Those who have fallen ill are reported to suffer coughs, fever and breathing difficulties. In severe cases there can be organ failure. As this is viral pneumonia, antibiotics are of no use. The antiviral drugs we have against flu will not work. If people are admitted to hospital, they may get support for their lungs and other organs as well as fluids. Recovery will depend on the strength of their immune system. Many of those who have died were already in poor health.
Is the virus being transmitted from one person to another?
Human to human transmission has been confirmed by China’s national health commission, and there have been human-to-human transmissions in the US and in Germany. As of 8 February, the death toll stands at 722 inside China, one in Hong Kong and one in the Philippines. Infections inside China stand at 31,161 and global infections have passed 280 in 28 countries. The mortality rate is 2%.
The number of people to have contracted the virus could be far higher, as people with mild symptoms may not have been detected. Modelling by World Health Organization (WHO) experts at Imperial College London suggests there could be as many as 100,000 cases, with uncertainty putting the margins between 30,000 and 200,000.
The number of confirmed cases of coronavirus in the UK has doubled from four to eight after four more people in Brighton were diagnosed with the infection over the weekend. One of the men is a doctor who was part of a group that were skiing in the resort near Chamonix with the man who is at the centre of the Brighton outbreak.
One of the other four confirmed cases is being treated at the HCID unit at the Royal Free hospital in north London and the two Chinese nationals who tested positive for Coronavirus in York are being treated at the HCID centre in Newcastle.
Why is this worse than normal influenza, and how worried are the experts?
We don’t yet know how dangerous the new coronavirus is, and we won’t know until more data comes in. The mortality rate is around 2%. However, this is likely to be an overestimate since many more people are likely to have been infected by the virus but not suffered severe enough symptoms to attend hospital, and so have not been counted. For comparison, seasonal flu typically has a mortality rate below 1% and is thought to cause about 400,000 deaths each year globally. Sars had a death rate of more than 10%.
Should I go to the doctor if I have a cough?
Unless you have recently travelled to China or been in contact with someone infected with the virus, then you should treat any cough or cold symptoms as normal. The NHS advises that people should call 111 instead of visiting the GP’s surgery as there is a risk they may infect others.
Is this a pandemic and should we panic?
Health experts are starting to say it could become a pandemic, but right now it falls short of what the WHO would consider to be one. A pandemic, in WHO terms, is “the worldwide spread of a disease”. Coronavirus cases have been confirmed in about 25 countries outside China, but by no means in all 195 on the WHO’s list.
There is no need to panic. The spread of the virus outside China is worrying but not an unexpected development. The WHO has declared the outbreak to be a public health emergency of international concern, and says there is a “window of opportunity” to halt the spread of the disease. The key issues are how transmissible this new coronavirus is between people and what proportion become severely ill and end up in hospital. Often viruses that spread easily tend to have a milder impact.
Sarah Boseley Health editor and Hannah Devlin
Professor Ian Mackay, a virologist at the University of Queensland, said that if cases were not being spotted, then there was a risk of further infection and new outbreaks emerging. “You’d be thinking close contacts – family, close friends maybe business meetings – could be then infected by these cases and this could set up a little hotspot of infection.”
Scientists do not believe the disease is airborne, he said. “So it’s not really simple to pick up – you do have to have some face-to-face time with someone in order to pass that virus on.”
Hopefully, Mackay added, people will report to a doctor if they are sick, and they will then be quarantined accordingly once their travel history is observed.
Reports have questioned the ability of Indonesia, the world’s fourth most populous country, to test for the virus, though the Indonesian health ministry said on Wednesday that it has all the necessary resources.
Indonesia, which receives significant Chinese investment, relies heavily on Chinese tourism. The country’s Chinese-Indonesians are estimated to make up roughly 3% of the population.
There is also concern over the thousands of Chinese tourists, including 200 people from Wuhan, who are reportedly stranded in Bali after direct flights to mainland China were banned by Indonesia. None of the tourists were showing symptoms, according to officials, but they are not in quarantine.
Citizens evacuated evacuated from Wuhan, however, remain under observation at a military base on the remote Natuna island, where residents have protested against their presence.
