Worries grow that quarantine in China not enough to stem increasingly virulent coronavirus - The Washington Post

Li Yun AP In this Jan. 26, 2020, photo released by Xinhua News Agency, a member of a military medical team takes over the work from a medical worker at Wuhan Jinyintan Hospital in Wuhan, central China's Hubei province.

Even as China takes more stringent measures to limit the movement of the vast country’s population during the biggest travel period of the year, there are increasing fears that the quarantine won’t be enough to stop the spread of the coronavirus. Here’s what we know:

● The government in Beijing broadened an extraordinary quarantine to more than 50 million people, but the mayor of the Wuhan epicenter said 5 million people succeeded in leaving the city already.

● China’s health minister said the coronavirus is increasing in virulence and now could be contagious even before people exhibit symptoms making perfectly healthy-seeming people possible carriers.

● A scientific assessment of the disease spread assuming an optimistic 90 percent quarantine still predicted more than 59,000 infections and 1,500 deaths — twice that of the 2002-3 SARS outbreak.

● China imposed a ban on the trade of wild animals until the coronavirus epidemic has been eliminated across the country, after evidence emerged that the disease was transmitted to humans through a market in the city of Wuhan that traded in game meat.

● In the United States, health officials confirmed a total of five cases, while further infections have been confirmed in France, South Korea, Japan, Nepal, Thailand, Singapore, Vietnam, Taiwan, the United States and Canada. We’re mapping the spread here.

WHAT WE KNOW ABOU THE CORONAVIRUS | SCENES FROM CHINA’S DEADLY CORONAVIRUS CRISIS

BEIJING — The mayor of Wuhan, the Chinese city at the center of the coronavirus outbreak, announced several stark numbers at a late-night news conference on Sunday, with most focusing on his prediction that there would be at least 1,000 new infections.

But Mayor Zhou Xianwang revealed another number that underscored the metastasizing challenge of the accelerating epidemic: 5 million.

That was the number of people who had emptied out of Wuhan in recent days — and scattered all over the world — as China’s Lunar New Year holiday period approached and authorities announced a lockdown in an urgent bid to contain the outbreak.

So far the virus has infected 2,744 people in China and killed 80, according to numbers provided by the National Health Commission Sunday night.

The effectiveness of an unprecedented quarantine around the viral epicenter in central China’s Hubei Province has become a key question as Chinese and international authorities ponder how to rein in the outbreak — and, at this point, whether it could be contained at all.

“Radical times call for radical measures,” said Dong-Yan Jin, a professor of molecular virology and oncology at Hong Kong University’s School of Biomedical Sciences. “A lot of cities have followed Wuhan in announcing a lockdown, but don’t forget that many potential patients are already out there before such an administrative order. Are we going to shut down the whole country?”

Jin said Chinese authorities had already passed the critical moment to control the epidemic: before the New Year travel rush began a week ago.

“There was a lack of transparency in Hubei and an unwillingness by local governments to face the music; now they tend to overcompensate,” he said. “You cannot expect that to work miracles and stop the outbreak.”

Escalating worldwide concerns, China’s health minister, Ma Xiaowei, said Sunday that people carrying the new coronavirus could infect others even while they do not show any symptoms for as long as 14 days, a period known as incubation. That implies that, unlike SARS, seemingly healthy travelers could have unwittingly infected others.

But international experts, including at the U.S. Centers for Disease Control, say they are still seeking to confirm Ma’s statement. Australia’s chief medical officer, Brendan Murphy, told reporters on Monday that expert panels were not yet convinced that the virus could be spread by people who were still symptom-free.

[Chinese coronavirus infections, death toll soar as fifth case is confirmed in U.S.]

Some researchers say even small degree of porousness in the quarantine effort could have magnified implications for the epidemic’s toll.

In a study published Saturday, Professor Yu Xiaohua at the University of Göttingen in Germany concluded that the epidemic cannot be controlled if the quarantine rate of the infectious population falls below 90 percent.

If 90 percent of patients are quarantined, his modeling suggested, the final number of cases might reach 59,000 with 1,500 deaths. But if only half the infected patients are quarantined, the final number of infected people could approach 5 million, with more than 100,000 deaths.

Cheng Min

AP

In this Jan. 26, 2020, photo released by Xinhua News Agency, members of a military medical team head for Wuhan Jinyintan Hospital in Wuhan, central China's Hubei province.

Yu, who is calling for a stricter polices to reach the 90 percent target, told The Post that the consequences of 5 million people already leaving Wuhan could turn out to be “huge.”

But he is also concerned about migrant workers from around the country returning to the big cities at the end of the New Year break, where they will live and work in close proximity to each other.

“The mobility of this huge population [of migrant workers] will cause the disease to spread again,” he said.

Even Yu’s optimistic scenario would make the current epidemic considerably more deadly than the 2002-3 SARS (severe acute respiratory syndrome) outbreak, which infected more than 8,000 people and killed nearly 800.

“Based on the Chinese system, 90 percent quarantine rate can be easily achieved, just by stopping people moving. The Communist Party can reach that goal,” he said, but warned that the economy would take a massive hit. One week's closure of the economy would shave 2 percentage points off the gross domestic product.

“How to balance that — that’s a political decision,” Yu said.

China’s cabinet, the State Council, announced Monday it would extend the Lunar New Year holiday period to reduce the number of travelers. Schools in cities like Beijing delayed the start of the spring semester by as much as two weeks.

On Monday, numerous Chinese city governments posted statements urging citizens who had recently traveled to the epidemic regions to quarantine themselves on their own accord.

[China’s coronavirus lockdown — brought to you by authoritarianism]

But already, stories are emerging of just how difficult it will be to enforce the quarantine.

Taiwanese authorities on Saturday fined an infected man who had traveled to Wuhan — and then hid his symptoms to enter Taiwan before going dancing in a nightclub. Eighty people were identified as coming into contact with the infected traveler, including a nightclub employee who showed symptoms of illness, Taiwanese state media reported.

Last week, a tourist from Wuhan boasted on Chinese social media that she took anti-fever pills to enter France and dine at an upscale Lyon restaurant. Over the weekend, Malaysian police detained a Chinese couple who were traveling with a child who showed influenza-like symptoms and refused to be quarantined.

Some medical experts warn that the number of cases may be higher than the authorities know or admit, and that the mass lockdown and efforts to quarantine patients are already too late due to the government's handling of the outbreak.

In a remarkable interview with the Chinese state broadcaster on Tuesday, Zhou, the Wuhan mayor, acknowledged that his city government had not disclosed information about the epidemic in a “timely and satisfactory” manner but appeared to blame the Chinese governance system.

“I hope everyone can understand that this is an infectious disease and infectious diseases must be disclosed according to law,” he said. “We can only disclose information after we receive authorization.”

He defended the decision to lock down the city.

“To seal a city of more than 10 million people has never been done before in human history,” he told CCTV. “We are willing to be removed from office to apologize to the world if that meant we could save people’s lives.”

Frustration was mounting among Wuhan residents, who said life and commerce had all but ground to a standstill inside the metropolis. A resident surnamed Zhang who lived on the Luoyu Road, a major Wuhan artery, said nearly all restaurants were closed and the streets were completely devoid of pedestrians.

AP

AP

In this Sunday, Jan. 26, 2020 photo, an ambulance drives along a street in Wuhan in central China's Hubei Province.

Daily shipments of fresh groceries to a supermarket that remained open were sold out by midday, he said.

Jan Renders, a Belgian Ph.D. student in Wuhan, said many pharmacies around the city were closed. A pharmacist that was still open sounded apologetic for charging him far higher prices than normal — about $16 — for two bottles of antibiotics and disinfectant, he said.

Chinese officials have acknowledged that a challenge remains providing medical supplies and care to the Hubei province countryside, where the disease could be spreading unabated.

[In Wuhan’s virus wards, plenty of stress but shortages of everything else]

A Chinese volunteer based in Sichuan province who has been coordinating nationwide donations to 130 hospitals in Hubei said the “lion’s share” of state resources have gone to Wuhan but smaller towns and rural villagers were in urgent need of masks and protective gear.

Huangmei County, located in Huanggang and with a population of a million, reported being short of a million face masks and a million surgical masks, said the volunteer, who asked to be identified by his surname, Luo.

“All of them are grappling with a rising number of patients and are running of supplies very soon,” Luo said.

In Hong Kong, everyone arriving from the mainland will have to sign a health declaration and could be subject to a penalty of six months in jail or a fine of about $650 for giving false information.

As the territory confirmed its eight case of the virus, authorities say they are considering stronger measures and have opened the possibility of a fuller ban on all mainland residents. Hong Kong this weekend has banned all Hubei residents from entering the territory, unless they are also Hong Kong residents.

“We have to consider whether it’s practical for us to ban all mainland residents from entering and leaving Hong Kong, and whether we can implement such a measure promptly,” said Health Secretary Sophia Chan.

In the United States, health officials confirmed three new cases — one in Arizona and two in California — bringing the total to five. The patients — in Southern California, Chicago, Arizona and Washington state — had traveled from Wuhan, officials with the Centers for Disease Control and Prevention said. All are hospitalized.

Health officials expect more American cases, Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, told reporters. But the virus is not believed to be spreading from person to person in the United States, she said.

Patients also have been confirmed in France, South Korea, Japan, Nepal, Thailand, Singapore, Vietnam, Taiwan and Australia.

Lyric Li in Beijing and Shibani Mahtani in Hong Kong contributed to this report.

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2020-01-27 10:21:00Z
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