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What You Need to Know About the Wuhan Coronavirus

A new coronavirus that emerged recently in Wuhan, China, is spreading between people. Consumer Reports explains what you need to know about the new disease.

By Kevin Loria and Lauren F. Friedman, Consumer Reports

  • There are 11 cases in the U.S. Nine of those people had traveled to China.
  • The State Department said travelers should not go to China.
  • The World Health Organization declared an international health emergency. The U.S. has also declared a public health emergency.
  • The virus causes respiratory problems that can range from a mild cough to severe pneumonia.
  • It can spread from person to person and continues to spread rapidly in China.
  • The CDC has placed 195 travelers flown from the outbreak epicenter to California in a two-week mandatory quarantine.
  • This article is being updated as the situation changes.

The coronavirus that emerged in Wuhan, China, at the end of last year has led to a global health emergency that now includes a State Department “do not travel” to China advisory and quarantines for some U.S. citizens who return home from there.

The extraordinary steps being taken are part of an all-out effort to halt the virus, which has left 20,490 confirmed cases and at least 425 deaths in China, according to a Johns Hopkins University database that aggregates government data. Those numbers surpass the cases and deaths caused by SARS in China during the 2002 to 2003 outbreak. And there most likely are more cases in China—a shortage of test kits available to confirm a coronavirus diagnosis means the current count may fall short, according to The New York Times.

There are a total of 159 confirmed cases outside of China, according to the World Health Organization. On Sunday, the first death was reported outside of China, in the Philippines. On Tuesday, a second death was reported outside mainland China, in Hong Kong.

In the U.S., there are 11 confirmed cases of the virus, which causes respiratory problems that can range from a mild cough to severe pneumonia. There are six cases in California, two in Illinois, and one each in Washington, Arizona, and Massachusetts. Most cases in the U.S. are in people who were recently in Wuhan, a city in the province of Hubei; two cases—one in Illinois and one in California—occurred when returning Wuhan travelers spread the virus to their spouses.

There are 260 potential cases under investigation in the U.S., according to the Centers for Disease Control and Prevention.

The State Department on Thursday issued a Level 4: Do Not Travel advisory, saying travelers should not go to China. In response, some airlines have canceled flights into and out of China, or are offering refunds. (More info for travelers below.)

Alex Azar, the secretary of Health and Human Services, on Friday declared a public health emergency in the U.S. and announced new measures that are likely to affect a large number of travelers.

Any U.S. citizen who has been in Hubei in the previous 14 days is now subject to a mandatory 14-day quarantine upon entry. Any U.S. citizen who has been to mainland China in the previous 14 days will be screened upon entry and then subject to up to 14 days of monitored self-quarantine. Furthermore, Azar said, any foreign national who has been to China in the previous 14 days will be denied entry into the U.S., unless they are an immediate family member of a citizen or permanent resident.

Azar said these restrictions are temporary but did not specify when or under what conditions they would be lifted.

U.S. officials have already quarantined 195 U.S. citizens. They were screened before departing Wuhan, flown out, screened again at a refueling stop in Anchorage, Alaska, and screen yet again upon arrival in California. At first, CDC officials said they would be monitored at an Air Force base for a few days. On Friday, the CDC announced the passengers would be quarantined for two weeks, citing evolving science on the new virus and its rapid spread through China. On Monday, the CDC announced that the State Department would be flying more U.S. passengers back from Wuhan, probably this week, with those passengers subject to quarantine on arrival.

“While we recognize this is an unprecedented action, we are facing an unprecedented public health threat,” Nancy Messonnier, M.D., director of the CDC’s National Center for Immunization and Respiratory Diseases, said during a media briefing.

“This strategy is not meant to catch every single traveler returning from China with novel coronavirus—given the nature of the virus and how it’s spreading, that would be impossible,” she said Monday. “The goal here is to slow the entry of the virus into the United States.”

“If we take strong measures now, we may be able to blunt the impact of the virus on the United States,” Messonnier added. “We are preparing as if this were the next pandemic.”

Chinese authorities, meanwhile, have shut down transit within and departing from more than a dozen cities, including Wuhan, which is home to more than 11 million people, about 650 miles south of Beijing.

WHO at first decided not to declare the outbreak a “public health emergency of international concern.” But on Thursday the organization revised that decision, saying that given the coronavirus’s spread to many countries—at least 19 so far—and multiple cases of human-to-human transmission outside of China, the agency was declaring a public health emergency of international concern.

“Over the past few weeks, we have witnessed the emergence of a previously unknown pathogen, which has escalated into an unprecedented outbreak and which has been met by an unprecedented response,” Tedros Adhanom Ghebreyesus, Ph.D., the director-general of WHO, said at a Thursday press conference. “Our greatest concern is the potential for the virus to spread to countries with weaker health systems and which are ill-prepared to deal with it.”

“We are working diligently with national and international public health partners to bring this outbreak under control as fast as possible,” he added, cautioning against “measures that unnecessarily interfere with international travel and trade.”

In the U.S., health officials have emphasized that most people have no reason to be concerned. “I understand that many people in the United States are worried about this virus and whether it will affect them,” the CDC’s Messonnier said Wednesday. “At this time, we continue to believe that the [risk] to the general public remains low.”

“This is a very fast-moving, constantly changing situation,” Azar said during a press conference Wednesday. “This is a potentially very serious health issue. . . . At the moment, there’s nothing individual Americans should be worried about.” On Friday, he reiterated that the risk to Americans was low and that the government would work to keep it that way.

Here’s what we know so far about this coronavirus. 

What Is This New Virus?

The disease does not yet have a name beyond “2019 novel coronavirus,” which indicates that the virus is a member of the large family of viruses known as coronaviruses. (Under a microscope, these viruses look like they have a crown, or corona.)

Coronaviruses are very common in animals, and many strains affect humans, according to Thomas File, M.D., president of the Infectious Diseases Society of America (IDSA). Most known coronaviruses cause mild conditions, such as the common cold and conjunctivitis, but the new virus is not the first time a coronavirus has led to hospitalizations and deaths.

“We have seen very serious manifestations of symptoms from other novel coronaviruses such as SARS and MERS,” File says. In 2002 to 2003, an outbreak of severe acute respiratory syndrome (SARS) sickened more than 8,000 people and killed 774. Almost 10 years later, another coronavirus, known as Middle East Respiratory Syndrome (MERS), emerged and has since infected 2,499 people and killed 861.

According to a study published Jan. 23 in JAMA, the fatality rate so far for the new virus seems to be lower than that of either SARS or MERS. But it’s too soon to know for sure, File says, because there’s no accurate gauge on the number of people who are sick. Many cases—especially less serious ones—could still be unreported.

While there’s a lot that we don’t yet know about the new coronavirus, researchers have genetically sequenced the pathogen, which provides some context for what’s happening, what sort of virus this is, and how it may be transmitted.

“From the genetic analysis, it does look like China detected this outbreak in humans very quickly,” says Lisa Maragakis, M.D., the hospital epidemiologist at The Johns Hopkins Hospital in Baltimore and the senior director of infection prevention at The Johns Hopkins Health System. Most of the confirmed cases in humans are similar enough genetically that it doesn’t appear to have been spreading for very long—though we don’t yet know how effective steps taken to stop the spread of the illness will be, she says.

According to the CDC, many of the first cases had links to a large seafood and live animal market in Wuhan. Genetic analysis has shown that the new virus has some similarities to other coronaviruses that circulate in bats and snakes.

How Does This Coronavirus Spread?

Respiratory viruses can vary greatly in terms of how quickly they spread.
Though the first cases of the new coronavirus seem to have spread from animals to people, the virus can also spread from person to person. Since those first reports, “the virus has continued to spread rapidly throughout China,” the CDC’s Messonnier said Friday. In the U.S., however, people should know that “this virus is not spreading in your community.”

An early analysis of the first 425 confirmed cases estimated that each infected person was spreading the virus to approximately 2.2 other people, according to a study published Jan. 29 in the New England Journal of Medicine. But the authors caution that this is a preliminary number, that it’s subject to change, and that the goal of control measures is to drive this number down.

As a respiratory virus, the coronavirus is likely to spread in air droplets when someone coughs or sneezes, according to File at the IDSA. If that’s the case, people within 5 or 6 feet of an infected person are most likely to get sick. Some respiratory viruses, including others in the coronavirus family, are known to spread when people touch a surface contaminated with infectious droplets, then touch their own nose, mouth, or eyes. And some respiratory viruses also remain aloft longer and spread through the air farther, according to Maragakis, so healthcare workers have been told to wear personal protective equipment. Though a number of healthcare workers have been infected so far, we don’t know whether they were wearing protective equipment or not.

At present, there’s no reason to think the pathogen could be transmitted through food or via consumer goods, according to a scientific risk assessment group that’s part of the German Federal Ministry of Food and Agriculture.

With the new coronavirus, people appear to get sick in a time frame of a couple of days to two weeks after being exposed.

Some reports have indicated that the new coronavirus may be contagious before people show symptoms. But experts who spoke to Science magazine said those reports may be flawed, in part because many people likely have mild symptoms without necessarily appearing very ill. 

Most outbreaks are primarily driven by diseases spread while people show symptoms, according to Anthony Fauci, M.D., director of the National Institute of Allergy and Infectious Diseases (NIAID), who spoke at the Jan. 28 press conference.

What Are the Symptoms?

There have been a wide range of symptoms so far, ranging from mild to severe. In most cases, people have had a fever and cough. In the more severe cases, people have developed pneumonia.

So far, about 20 percent of people who are confirmed to have been infected experience severe illness, according to WHO, though it’s likely that there are more mild cases that have never been confirmed.

Who Is at Risk?

Most of the known cases are clustered in and around Wuhan, and in people who have recently returned from the region. We’re still in the early phases of understanding which segments of the population are most at risk of infection and complications, according to Maragakis.

In general, “elderly patients and those with underlying diseases tend to do worse with any pneumonia,” says Richard Wunderink, M.D., a professor of medicine at the Northwestern University Feinberg School of Medicine in Chicago who has written about coronaviruses. “However, younger people may be [more likely to catch the virus] for multiple social rather than medical reasons.”

Taking precautions may be especially important for “healthcare workers, who were disproportionately affected by the SARS epidemic,” Wunderink says.

For Americans, the two main risk factors are recent travel to Hubei province and close contact with people who have traveled recently to Hubei province. People who are not in one of those two groups do not need to be concerned at this point, the CDC’s Messonnier said Wednesday.

What Should Travelers Know About the Virus?

The State Department said Thursday that travelers should not go to China, stepping up its earlier “reconsider travel” to China message. Secretary of State Mike Pompeo cited the spread of the virus and WHO’s emergency designation in making the announcement on Twitter.

British Airways announced Wednesday that it was canceling all flights to and from mainland China, after the British Foreign Office advised avoiding all nonessential travel to the country. Later that same day, Lufthansa announced it would also suspend all flights to and from mainland China through Feb. 9, and Air Canada announced it would suspend all direct flights to Beijing and Shanghai through Feb. 29.

After the State Department upgraded its travel warning Thursday, American Airlines, Delta, and United announced they would temporarily suspend all regular flights to mainland China from the U.S. (The airlines’ sites have more information on the specific dates of the suspensions and what to do if you have a booking.)

In general, travelers should remain vigilant and keep up to date with the latest advisories from the CDC, Maragakis says.

As of 5 p.m. Eastern Standard Time Sunday, any U.S. citizen who has been in Hubei during the previous 14 days will be quarantined upon arrival in the U.S. Anyone who has been in mainland China will be screened. And any noncitizen who has been in China during the previous 14 days will be denied entry.

People who have recently traveled to an affected area should contact health officials if they notice any symptoms of infection. The CDC is distributing hundreds of thousands of educational cards to arriving travelers so that people can be on the lookout for any symptoms that might be the new coronavirus.

In the case of the first two U.S. patients identified, both had re-entered the U.S. before airport screening of those coming from Wuhan had begun. They each contacted their healthcare providers because of their symptoms and travel history. 

How Should You Protect Yourself?

If you are in or have to travel to an affected region, Maragakis says you should take the same precautions as you might for any respiratory condition: Try to avoid sick people, wash your hands frequently, cover your nose and mouth if you cough or sneeze, and try not to go out if you are sick.

The CDC does not recommend the use of face masks by the general public in the U.S., Messonnier said during a Jan. 30 media briefing.

Otherwise, although this is “the beginning of what could be a large outbreak,” she says, it’s far away from the U.S. And at this point, there have been only a relatively small number of cases outside of China. Still, the new outbreak should serve as a reminder that very severe respiratory viruses tend to circulate every few years.

“We do have tens of thousands of people who die of flu every year in this country,” she says. To protect yourself from that, she and File agree, you should get a flu shot.

What Experts Still Don't Know

“Almost every day, we’re learning things we didn’t know before,” Robert Redfield, M.D., CDC director, said at a Friday press conference.

We still need to learn exactly how the virus spreads from person to person and how likely people are to get sick when they’re exposed, Maragakis says.

We also need more data to understand the mortality rate, File says.

Even the sensitivity of the test developed to diagnosis the virus is still unknown, the NIAID’s Fauci said at a Friday press conference.

Overall, says File, who was in China in March 2003 when WHO first issued a travel advisory for SARS, “this is almost like déjà vu.” But in this case, at least, the virus seems to have been identified much more quickly.

The CDC describes this as a “rapidly evolving situation,” and says information will be updated as it becomes available.

See more at Consumer Reports


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dearJulius.com: What You Need to Know About the Wuhan Coronavirus
What You Need to Know About the Wuhan Coronavirus
A new coronavirus that emerged recently in Wuhan, China, is spreading between people. Consumer Reports explains what you need to know about the new disease.
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