The growing coronavirus epidemic is isolating China, as other countries, trying to ward off infection or contain their own smaller outbreaks bar, entry to travellers from China, and companies including Apple scale down travel and business there.
The UK announced on Saturday it had withdrawn all but essential staff from embassies and consulates in China, as authorities at home dealt with fallout from the first two cases confirmed in Britain – a student at the University of York and a visiting relative.
The university’s vice-chancellor, Charlie Jeffery, said that although he understood the diagnoses would “cause concern and anxiety”, it would not disrupt studies. “We’re working closely with the lead agency, Public Health England, and other agencies to manage this situation,” he said.
The two patients are now under quarantine in Newcastle, and the York hotel room they had been staying in has been disinfected. The university said the student is not believed to have come into contact with anyone on campus while they had symptoms.
Authorities are trying to trace people who had “close contact” with the pair – which is defined as spending at least 15 minutes within two metres of the infected person.
In total, 203 people have been tested for the disease in Britain, and only two results have been positive. The vast majority of infections and all deaths are still inside China, and concentrated in Hubei province. By Saturday, 13,968 cases and 304 deaths had been confirmed, 45 of them overnight in Hubei province. But the rapid spread of the virus beyond Chinese borders has raised fears that other countries could face large-scale outbreaks, and many governments are taking increasingly strong measures to prevent an epidemic on their territory.
On Saturday, Australia followed the US by imposing a ban on entry to most travellers from China. Canberra said citizens, residents or relatives would still be allowed in. Countries including Uzbekistan and Vietnam cancelled flights from China altogether.
Dozens of commercial carriers have cut back or halted flights to China, and several hotel chains have said they will allow cancellations by Chinese travellers. Major companies such as Google and Facebook have banned travel to the country, while international retailers such as Starbucks and Apple have shut stores.
In Hong Kong, where there are strong memories of the impact of the 2003 Sars outbreak, thousands of hospital staff went on strike, demanding that authorities close the border.
Britain has not yet brought in similar bans, but precautions are being increased. Eighty-three British nationals flown out of Wuhan on Friday spent their second night of two weeks in quarantine at Arrowe Park hospital in Wirral yesterday.
The University of Derby also asked a “very small number” of students who left Wuhan before restrictions were imposed to self-isolate for 14 days. All are currently well.
A UK-wide public health campaign is to be launched on Sunday urging people to use tissues and wash their hands regularly to help stop the spread of the virus. The message will be in adverts in newspapers and on radio and online forums known to be used by Chinese nationals living here.
Cases of human-to-human transmission, which has driven the fast rise in infections inside China, have been detected in Germany, Thailand, Taiwan, France, Japan and the US.
“The real issue now for the world is what happens outside China,” Sir Jeremy Farrar, director of the Wellcome Trust, told the BBC. “What we need to look out for now is when does [it] start to spread – if it spreads – in the community or between people outside China itself. And that will be the signal that actually other countries may suffer from the same sorts of issues we see in China.”
He said the severity of any wider outbreak could lie anywhere between something like seasonal winter flu and “something akin to what we are seeing in China at the moment”.
“The uncertainty at the moment means we cannot be sure which pathway this epidemic is going to take,” Farrar added.
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?
Human to human transmission has been confirmed by China’s national health commission. As of 3 February, 361 people have died in China, and one in the Philippines. Confirmed infections in China are 17,238, and the official Chinese figures include Taiwan, Hong Kong and Macau. Outside of China, infections stand at more than 150.
Two members of one family have been confirmed to have the virus in the UK, after more than 160 were tested and found negative. The actual number 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.
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 and Hannah Devlin
Modelling published in the Lancet suggested more than 75,000 people could have been infected in Wuhan a week ago, about 50 times higher than the official worldwide total of cases at the time. If the transmissibility of the disease was “similar everywhere”, the paper said, epidemics could already be “growing exponentially in multiple major cities of China with a lag time behind the Wuhan outbreak of about one to two weeks”.Inside China, quarantine rules that have put around 50 million people on lockdown are being tightened in some places.
Huanggang, the second-worst-affected city, with over 700 infections and 14 deaths, has effectively confined almost everyone to their homes. One person from each family will be allowed out to get food every two days, although there are exceptions for medical workers, sick people seeking treatment, and those staffing supermarkets and hospitals.
Elsewhere, local governments have pushed back the end of the lunar new year break; schools and universities will not resume classes this week as planned, and in some places factories have been told to delay restarting work.
People have been urged to delay weddings, particularly the large numbers planned for today, 2 February – a popular date because, written as a sequence of numbers, it is a palindrome: “02 02 2020”.
Even funerals are under pressure, with families asked to keep mourning “simple and expeditious” to avoid gatherings. Bodies of coronavirus victims are to be cremated as soon as possible.
