On 12 January Huang got news his healthy 65-year-old mother had been checked into a hospital in the central Chinese city of Wuhan with a fever and a cough.
There had been reports of a strange new virus with similar symptoms, and the hospital staff were dressed in full hazmat suits. Still, Huang’s mother was not tested for the mystery illness, nor quarantined from other patients.
On 14 January she took a turn for the worse and was slipping in and out of consciousness. A CT scan showed her lungs covered in white nodules. The next evening, Huang’s brother and father watched her die. The official cause of death was severe pneumonia. Two doctors told the family privately that she had probably contracted the virus, but provided no documentation.
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, or possibly seafood. New and troubling viruses usually originate in animal hosts. Ebola and flu are examples.
What other coronaviruses have there been?
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 are known to have been already in poor health.
Is the virus being transmitted from one person to another?
In the past week, the number of confirmed infections has more than tripled and cases have been found in 13 provinces, as well as the municipalities Beijing, Shanghai, Chongqing and Tianjin. The virus has also been confirmed outside China, in Hong Kong, Macau, Japan, Nepal, Singapore, South Korea, Taiwan, Thailand, the US, and Vietnam. There have not been any confirmed cases in the UK at present, with the 14 people tested for the virus all proving negative. The actual number to have contracted the virus could be far higher as people with mild symptoms may not have been detected.
How worried are the experts?
There were fears that the coronavirus might spread more widely during the week-long lunar new year holidays, which start on 24 January, when millions of Chinese travel home to celebrate, but the festivities have largely been cancelled and Wuhan and other Chinese cities are in lockdown.
At what point should you go to the doctor if you have a cough, say?
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 there is generally no need to visit a doctor for a cough unless it is persistent or you are having other symptoms such as chest pain, difficulty breathing or you feel very unwell.
Should we panic?
No. The spread of the virus outside China is worrying but not an unexpected development. It increases the likelihood that the World Health Organization will declare the outbreak to be a public health emergency of international concern on Thursday evening. The key concerns are how transmissible this new coronavirus is between people and what proportion become severely ill and end up in hospital.
Sarah Boseley Health editor, Hannah Devlin and Martin Belam
The hospital pressured the family to immediately cremate Huang’s mother, but they refused, asking for more information. A few days later, they relented and workers from a funeral home, also in protective clothing, retrieved, cremated and buried her within a few hours, leaving the family no time to say goodbye. Afterwards, the staff disinfected the van they had travelled in and threw away their hazmat suits.
“My mother’s death was dealt with without any dignity,” said Huang, 40, who did not want to give his or his mother’s full name. “She wasn’t even counted as a number on the government’s list,” he said, referring to the six people authorities say have been killed by the virus.
China is on high alert as a new strain of coronavirus – first detected in Wuhan – spreads across the country. If hospitals are not screening for the virus then the number of cases, and deaths, could be much higher than those cited in official reports.
Authorities reported three more deaths on Tuesday: an 89-year-old male, a 66-year-old male and a 48-year-old female. The government has confirmed 308 cases, with 270 of them in Hubei province, of which Wuhan is the capital.
Cases have been confirmed in Beijing, Shanghai, Chongqing, and Tianjin, as well as the provinces Henan, Zhejiang and Guangdong. Suspected cases have been flagged in 13 provinces across the country – many of them hundreds of miles away from Wuhan. Fifteen health workers in Wuhan have also been infected, according to authorities.
The number of confirmed infections is likely to have been underestimated, according to international public health experts, who say there could be as many as 1,700 cases.
On the microblog Weibo, another Wuhan resident posted images of her mother’s diagnosis of viral pneumonia and described the long queues of patients with similar symptoms late on Monday night, none of whom appeared to have been tested for coronavirus. “Could all these people suddenly have viral pneumonia?” she said.
Another Weibo user complained earlier this month that his father showed the symptoms of the virus but was sent home from the hospital without any screening. The post later disappeared.
The World Health Organization has said the recent rise in cases is a sign authorities are now more aggressively screening for the virus. It will consider declaring an international public health emergency – as it did with swine flu and Ebola – on Wednesday.
The Chinese political body responsible for law and order said on Tuesday that lower-ranking officials who covered up the spread of the virus would “be nailed on the pillar of shame for eternity”.
During the Sars outbreak in the early 2000s, China initially withheld information about it from the public and vastly underreported cases of infection. The virus, which was also caused by a coronavirus, killed 774 people.
Late on Monday, China’s National Health Commission confirmed that the new virus could be spread through human-to-human contact, heightening outbreak fears before the country’s week-long lunar new year holiday, which starts on Friday and during which hundreds of millions of people travel across the country.
On Tuesday internet users posted photos of shops with shelves emptied of face masks. The price of protective face masks sold online has at least doubled, prompting criticism from the state-run China Daily paper, which described the behaviour of sellers as “immoral”. In Beijing, many commuters wore masks indoors and on the subway.
In Wuhan, authorities have begun to control the number of people leaving and entering the city, according to state TV. Guards are keeping a 24-hour watch on the now closed Huanan seafood and animal market, suspected as the source of the outbreak. Tour groups are barred from leaving and random spot checks are being conducted on vehicles coming in and out of the city to see whether they carry live animals.
Advice online has ranged from washing one’s hands to not using the self-service screens at McDonald’s. Some people said they had cancelled plans to travel home for the holidays. Some internet users posted notices from their employers giving them permission to work from home this week.
At the crematorium in Wuhan, Huang said he met one other family whose relative had died in similar circumstances.
He was not sure how his mother would have caught the virus. She had not gone to the seafood market, and was healthy and active. “Everyone said she was a good person – always helping people,” he said. “In the end, she died alone and no one had a chance to say goodbye.”
